Active NPI
Angela Gremillion Ferguson, D.O.
- Internal Medicine Physician
- Lubbock, TX
National Provider Identifier
1104067909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- P7436
- Practice address
- 9812 Slide Rd
Lubbock, TX 79424-5781 - Phone
- (806) 725-8765
- Fax
- (806) 725-8758
- NPI assigned
- Mar 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | P7436 | TX | Primary |
| Internal Medicine Physician | 207R00000X | A-1661-12 | NM |
Addresses
Primary practice location
9812 Slide Rd
Lubbock, TX 79424-5781
Mailing address
3420 22ND PL
Lubbock, TX 79410-1314
Phone (806) 725-5844
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83308539 | Medicaid | NM | |
| 8DY748 | Other | TX | BCBS TX |
| 960091100 | Other | TX | FIRSTCARE |
| 326015001 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131101000351 | TX | Practitioner - Internal Medicine | 6608047436 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Covenant Medical Group
Practice addresses (Care Compare)
2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844
3601 21St St
Lubbock, TX 79410-1229
Phone (806) 791-0399
9812 Slide Rd
Lubbock, TX 79424-5781
Phone (806) 725-8400
Hospital & facility affiliations
- Beyondfaith Homecare & Rehab LLC
- Excelacare Home Health
- Covenant Medical Center
- Covenant Childrens Hospital
- Grace Surgical Hospital
- University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-1661-12 | NM | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group | Internal Medicine | Current | Accepting new patients |
| Covenant Medical Group | Current | Accepting new patients | |
| Park Lenox Medical, PC | Internal Medicine | Past | Accepting new patients |
| LHHN Medical, P.C. | Internal Medicine | Past | Accepting new patients |
Locations
2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228
3420 22nd Pl
Lubbock, TX 79410
Phone (806) 725-1800
9812 Slide Rd
Lubbock, TX 79424
Phone (806) 725-1000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Abernathy, TX
- NPI 1538412895
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Lubbock, TX
- NPI 1346247434
-
- Home Health Agency
- Lubbock, TX
- NPI 1710927983
-
- Ambulatory Surgical Clinic/Center
- Lubbock, TX
- NPI 1538245717
Hospital
-
- Hearing and Speech Clinic/Center
- Lubbock, TX
- NPI 1831299114
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1104067909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 22ND PL",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101314",
"telephone_number": "806-725-5844",
"fax_number": "806-723-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9812 SLIDE RD",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794245781",
"telephone_number": "806-725-8765",
"fax_number": "806-725-8758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "ANGELA",
"middle_name": "GREMILLION",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-09",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "P7436",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NM",
"license": "A-1661-12",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "83308539",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TX",
"identifier": "8DY748",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE",
"identifier": "960091100",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "326015001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.