Individual provider Active NPI

John David Ferguson

  • Hospitalist Physician
  • Benton, AR
National Provider Identifier
1104387562
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
E-15439 Issued in AR
Practice address
5 Medical Park Dr Ste 304
Benton, AR 72015-3745
Phone
(501) 408-2429
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X E-15439 AR
Hospitalist Physician 208M00000X E-15439 AR Primary

Addresses

Primary practice location

5 Medical Park Dr Ste 304
Benton, AR 72015-3745

Mailing address

2420 Riverfront Dr Apt 311
Little Rock, AR 72202-1762
Phone (501) 690-4004

Other practice location 1

4301 W Markham St # 634
Little Rock, AR 72205-7101
Phone (501) 686-5162

Other practice location 2

1808 W Main St
Russellville, AR 72801-2724
Phone (479) 968-2841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725001130 AR Practitioner - Internal Medicine 2264766229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient SolutionsGroup PAC ID 5597195206, 31 clinicians

Practice addresses (Care Compare)

5 Medical Park Dr
Suite 304
Benton, AR 72015-3745
Phone (501) 408-2429

Hospital & facility affiliations

  • Saline Memorial Hospital Hospital, Benton, AR, CCN 040084
  • Arkansas Heart Hospital-Encore Hospital, Bryant, AR, CCN 040161
  • Arkansas Surgical Hospital Hospital, No Little Rock, AR, CCN 040147
  • Arkansas Heart Hospital, LLC Hospital, Little Rock, AR, CCN 040134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Physician Services LLC Single Specialty CurrentSince Apr 13, 2023 Accepting new patients
Inpatient Solutions Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
St Marys Physician Services, LLC Single Specialty CurrentSince Apr 13, 2023 Accepting new patients
St Marys Physician Services, LLC Single Specialty Past Accepting new patients

Locations

5 Medical Park Dr
Ste 304
Benton, AR 72015
Phone (501) 408-2429

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

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.

Hospital & facility affiliations 5

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1104387562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 RIVERFRONT DR APT 311",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722021762",
            "telephone_number": "501-690-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DR STE 304",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153745",
            "telephone_number": "501-408-2429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 634",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-5162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1808 W Main St",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012724",
            "country_code": "US",
            "telephone_number": "479-968-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15439",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-15439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.