Individual provider Active NPI

Kevin Wimberley Fergusson, M.D.

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1083755003
Registry record updated Nov 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101040026 Issued in VA
Practice address
701 E Byrd St
Richmond, VA 23219-3921
Phone
(804) 663-6008
NPI assigned
Feb 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101040026 VA Primary

Addresses

Primary practice location

701 E Byrd St
Richmond, VA 23219-3921

Mailing address

8654 Rio Grande Rd
Richmond, VA 23229-7823
Phone (804) 740-7133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CADGAA/Endpoint/CADGAA

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351987200000",
    "number": "1083755003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8654 RIO GRANDE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232297823",
            "telephone_number": "804-740-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E BYRD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193921",
            "telephone_number": "804-663-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSSON",
        "first_name": "KEVIN",
        "middle_name": "WIMBERLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-11",
        "last_updated": "2012-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101040026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2012; 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.