Individual provider Active NPI

Taylor Ferguson

  • Marriage & Family Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1194192971
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3055 Issued in FL
Practice address
348 Miracle Strip Pkwy SW
Suite B-3
Fort Walton Beach, FL 32548-5200
Phone
(850) 862-3772
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT3055 FL Primary

Addresses

Primary practice location

348 Miracle Strip Pkwy SW
Suite B-3
Fort Walton Beach, FL 32548-5200

Mailing address

895 Solimar Way
None
Mary Esther, FL 32569-1421
Phone (850) 226-1246

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

LicenseStateTypeSpecialty
MT3055FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Child Development of Northwest Florida, Inc. Marriage & Family Therapist Past Accepting new patients
Family and Child Development Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1194192971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 SOLIMAR WAY",
            "address_2": "NONE",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691421",
            "telephone_number": "850-226-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE B-3",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "850-862-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.