Active NPI
Susan Fergeson, SLP
- Speech-Language Pathologist
- Breckenridge, TX
National Provider Identifier
1154802478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 102737
- Practice address
- 1510 W Elliott St
Breckenridge, TX 76424-4106 - Phone
- (817) 879-1565
- NPI assigned
- Aug 24, 2018
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 102737 | TX | Primary |
Addresses
Primary practice location
1510 W Elliott St
Breckenridge, TX 76424-4106
Mailing address
1510 W Elliott St
Breckenridge, TX 76424-4106
Phone (817) 879-1565
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102737 | TX | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1154802478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 W ELLIOTT ST",
"city": "BRECKENRIDGE",
"state": "TX",
"postal_code": "764244106",
"telephone_number": "817-879-1565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 W ELLIOTT ST",
"city": "BRECKENRIDGE",
"state": "TX",
"postal_code": "764244106",
"telephone_number": "817-879-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGESON",
"first_name": "SUSAN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-24",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "102737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.