Individual provider Active NPI

Nikita Jackson Fergins, FNP-C

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1124691639
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
220856 Issued in LA
Practice address
2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918
Phone
(318) 631-6400
NPI assigned
Jul 22, 2021
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 220856 LA Primary

Addresses

Primary practice location

2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918

Mailing address

9516 Castlebrook Dr
Shreveport, LA 71129-4810
Phone (318) 422-3995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20211123000330 LA Practitioner - Nurse Practitioner 8325437874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2120 Bert Kouns Industrial Loop
Shreveport, LA 71118-3351
Phone 31868833501230

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
220856LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Advancement of Social Service and Education CurrentSince Dec 2, 2024 Accepting new patients
Council for Advancement of Social Service and Education CurrentSince Dec 2, 2024 Accepting new patients
Council for Advancement of Social Service and Education Past Accepting new patients
Council for Advancement of Social Service and Education PastSince Aug 2, 2020 Accepting new patients

Locations

2120 Airline Dr
Bossier City, LA 71111
Phone (318) 688-3350

907 Polk St
Mansfield, LA 71052
Phone (318) 688-3350

1560 Irving Pl
Shreveport, LA 71101
Phone (318) 212-1194

2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 688-3350

2120 Bert Kouns Industrial Loop
Ste H
Shreveport, LA 71118

149 Stone Creek Rd
Stonewall, LA 71078
Phone (318) 688-3350

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1124691639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9516 CASTLEBROOK DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711294810",
            "telephone_number": "318-422-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033918",
            "telephone_number": "318-631-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGINS",
        "first_name": "NIKITA",
        "middle_name": "JACKSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "220856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.