Individual provider Active NPI

Edward Wayman Ferguson Jr., MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1205947041
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
106904 Issued in MO
Practice address
625 S New Ballas Rd
Saint Louis, MO 63141-8253
Phone
(314) 251-6090
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 106904 MO Primary

Addresses

Primary practice location

625 S New Ballas Rd
Saint Louis, MO 63141-8253

Mailing address

7489 Washington Ave
University City, MO 63130-4050
Phone (314) 369-4153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040108000177 MO Practitioner - Emergency Medicine 4587563523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jan 22, 2020 Accepting new patients
Mercy Aco Clinical Services Inc Emergency Medicine CurrentSince Mar 7, 2020 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1605 Martin Springs Dr
Ste 110
Rolla, MO 65401
Phone (573) 458-6300

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

625 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-0175

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

625 S New Ballas Rd
Ste BO11
Saint Louis, MO 63141

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1205947041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7489 WASHINGTON AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631304050",
            "telephone_number": "314-369-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "EDWARD",
        "middle_name": "WAYMAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "106904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.