Active NPI
Kim Ferguson, PSYD
- Psychologist
- Concord, NC
National Provider Identifier
1154375483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1642
- Practice address
- 380 Copperfield Blvd NE
Concord, NC 28025-2402 - Phone
- (704) 403-1800
- NPI assigned
- May 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1642 | NC | Primary |
Addresses
Primary practice location
380 Copperfield Blvd NE
Concord, NC 28025-2402
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
100 Medical Park Dr
Suite 310
Concord, NC 28025-2948
Phone (704) 403-2660
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Ambulatory@direct.carolinashealthcare.org | Atrium Health |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Charlotte-Mecklenburg Hospital Authority | Psychologist | Past | Accepting new patients |
Interoperability endpoints
- ambulatory@direct.carolinashealthcare.org
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 and National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Concord, NC
- NPI 1063849420
Psychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1154375483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 COPPERFIELD BLVD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252402",
"telephone_number": "704-403-1800"
}
],
"practiceLocations": [
{
"address_1": "100 Medical Park Dr",
"address_2": "Suite 310",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252948",
"country_code": "US",
"telephone_number": "704-403-2660",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FERGUSON",
"first_name": "KIM",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2021-09-27",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1642",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Ambulatory@direct.carolinashealthcare.org",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "380 Copperfield Blvd NE",
"city": "Concord",
"state": "NC",
"country_code": "US",
"postal_code": "280252402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.