NPIMap

Organization Active NPI

Dr. Ricky Ferguson Vision Center PA

  • Optometrist
  • Monticello, AR
National Provider Identifier
1053446732
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2309 Issued in AR
Legal business name
DR. RICKY FERGUSON VISION CENTER PA
Practice address
408 W McCloy St
Monticello, AR 71655-4325
Phone
(870) 367-8511
Fax
(870) 367-3215
NPI assigned
Feb 22, 2007
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ricky Carroll Ferguson, O.D.NPI 1720198963
Title
Owner
Phone
(870) 367-8511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2309 AR Primary

Addresses

Primary practice location

408 W McCloy St
Monticello, AR 71655-4325

Mailing address

408 W McCloy St
Monticello, AR 71655-4325
Phone (870) 367-8511

Other identifiers 2

IdentifierTypeStateIssuer
138899722MedicaidAR
410040927OtherARMEDICARE RAILROAD

Other names 1

  • The Vision Center Other name

National Provider Directory

National Provider Directory

Locations

408 W McCloy St
Monticello, AR 71655
Phone (870) 367-8511

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1053446732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W MCCLOY ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554325",
            "telephone_number": "870-367-8511",
            "fax_number": "870-367-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W MCCLOY ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554325",
            "telephone_number": "870-367-8511",
            "fax_number": "870-367-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RICKY FERGUSON VISION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-367-8511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138899722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410040927",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Vision Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.