Individual provider Active NPI

Thomas Jamel Ferguson, PA

  • Physician Assistant
  • Nags Head, NC
National Provider Identifier
1083323042
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4917 S Croatan Hwy Ste 1a
Nags Head, NC 27959-8996
Phone
(252) 449-6160
Fax
(252) 449-6161
NPI assigned
Nov 18, 2022
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4917 S Croatan Hwy Ste 1a
Nags Head, NC 27959-8996

Mailing address

226 Sunset Dr
Kill Devil Hills, NC 27948-8660
Phone (919) 352-6708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403002326 NC Practitioner - Physician Assistant 7416322532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2518 S Croatan Hwy
Unit B
Nags Head, NC 27959
Phone (252) 449-7373

4810 S Croatan Hwy
Suite 250
Nags Head, NC 27959
Phone (252) 449-9120

4917 S Croatan Hwy
Suite 1a
Nags Head, NC 27959-8996
Phone (252) 449-6160

4917 S Croatan Hwy
Suite 1B
Nags Head, NC 27959
Phone (252) 255-0583

4927 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 261-0777

5002 S Croatan Hwy
Nags Head, NC 27959-9045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Mar 20, 2023 Accepting new patients

Locations

4917 S Croatan Hwy
Ste 1A
Nags Head, NC 27959
Phone (252) 449-2100

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1083323042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 SUNSET DR",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279488660",
            "telephone_number": "919-352-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY STE 1A",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598996",
            "telephone_number": "252-449-6160",
            "fax_number": "252-449-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "THOMAS",
        "middle_name": "JAMEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

Verify at the official NPI Registry.