Individual provider Active NPI

Javan Ferguson, M.D.

  • Hospitalist Physician
  • Atlanta, GA
National Provider Identifier
1174597314
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
54712 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2208
Phone
(404) 686-6730
Fax
(404) 686-4837
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 54712 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2208

Mailing address

550 Peachtree St NE
Atlanta, GA 30308-2208
Phone (404) 686-6730

Other identifiers 3

IdentifierTypeStateIssuer
50267OtherFLBCBS
298203OtherFLAVMED
270734900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150331001834 GA Practitioner - Internal Medicine 3971563065 Reassigns benefits to 2 organizations
I20170725000815 TN Practitioner - Internal Medicine 3971563065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54712GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Hospitalist CurrentSince Jan 1, 2015 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Aug 1, 2016 Accepting new patients
App of Tennessee HM, PLLC Hospitalist CurrentSince Nov 11, 2019 Accepting new patients
Phoebe Dorminy Kids Health CurrentSince Aug 1, 2016 Accepting new patients
Southeastern Physician Services PC Hospitalist CurrentSince May 1, 2017 Accepting new patients
Hospital Care Associates PA Past Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: jferguson38745@direct.emory.org

Organizations & group practices 6

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 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1174597314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-6730",
            "fax_number": "404-686-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-686-6730",
            "fax_number": "404-686-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JAVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "54712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50267",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "298203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270734900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.