Kyle Edward Ferguson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60129975 Issued in WA

Practice address

525 Lilly Rd NE
Olympia, WA 98506-5101

Phone

(360) 493-7230

NPI assigned

Sep 13, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Puyallup Tribal Health Authority

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1063455665
  Medicare reassignment NPD
• Squaxin Island Tribe

  • Clinic/Center
  • Shelton, WA
  • NPI 1669532578
  Medicare reassignment NPD
• Puyallup Tribal Health Authority

  • Adult Mental Health Clinic/Center
  • Tacoma, WA
  • NPI 1255378782
  NPD

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1164739058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KYLE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60129975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Mark Fenwick, PH.D, LMHC, CDP
• April Marie Ferguson, M.D.
• Ashley Anne Ferguson, DPT
• Jill Ferguson, LP00030754
• Jody Lee Ferguson, LMHC
• Samantha Ferguson, PA-C
• Fern Haven Center
• Eric Fernandez, LMT
• Shaneen S Fernandez, DNP, CNM, ARNP
• Aurora Claire Fernwood, M.S., LMFT

• Clinical Psychologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.