Individual provider Active NPI

Keron Alicia Ferguson, M.D.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Maitland, FL
National Provider Identifier
1215007125
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
ME94429 Issued in FL
Practice address
2400 Maitland Center Pkwy Ste 310
Maitland, FL 32751-7442
Phone
(407) 426-4800
Fax
(407) 426-4820
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME94429 FL
Family Medicine Physician 207Q00000X ME94429 FL
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ME94429 FL Primary

Addresses

Primary practice location

2400 Maitland Center Pkwy Ste 310
Maitland, FL 32751-7442

Mailing address

222 Broadway Unit 301
Kissimmee, FL 34741-5767
Phone (407) 846-8180

Other practice location 1

2400 Maitland Center Pkwy Ste 310
Maitland, FL 32751-7442
Phone (352) 329-1800

Other practice location 2

222 Broadway
Suite 301
Kissimmee, FL 34741
Phone (407) 846-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070801000657 FL Practitioner - Family PracticePractitioner - General PracticePractitioner - Geriatric MedicinePractitioner - Undersea and Hyperbaric Medicine 4284725565 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Undersea and Hyperbaric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Wound and Healing PAGroup PAC ID 2860730041, 12 clinicians
House Call M.D.'S L.L.CGroup PAC ID 5496033839, 12 clinicians
Kopa LLCGroup PAC ID 5193774461, 40 clinicians

Practice addresses (Care Compare)

2400 Maitland Ctr Pkwy
Suite 310
Maitland, FL 32751-7442
Phone (352) 329-1800

5900 Lake Ellenor Dr
Suite 700
Orlando, FL 32809-4643
Phone (407) 352-2542

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue307
Removal of skin lesions566
Removal or shaving of skin growth1-10
Skin biopsy12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kopa LLC CurrentSince May 1, 2025 Accepting new patients
Nautilus Health Care Group, LLC Undersea and Hyperbaric Medicine CurrentSince Jul 21, 2014 Accepting new patients
Nautilus Health Care Group LLC Family Medicine CurrentSince Jul 21, 2014 Accepting new patients
House Call M.D.'S L.L.C. Family Medicine CurrentSince Mar 31, 2025 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients

Locations

715 W State Road 434
Longwood, FL 32750
Phone (407) 767-5843

2400 Maitland Center Pkwy
Ste 310
Maitland, FL 32751
Phone (352) 329-1800

2000 N Semoran Blvd
Orlando, FL 32807
Phone (407) 641-5400

7339 Stonerock Cir
Orlando, FL 32819
Phone (321) 842-7308

5900 Lk Ellenor Dr
Ste 700
Orlando, FL 32809
Phone (407) 216-0101

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1215007125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 BROADWAY UNIT 301",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415767",
            "telephone_number": "407-846-8180",
            "fax_number": "800-517-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MAITLAND CENTER PKWY STE 310",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517442",
            "telephone_number": "407-426-4800",
            "fax_number": "407-426-4820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Maitland Center Pkwy Ste 310",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517442",
            "country_code": "US",
            "telephone_number": "352-329-1800",
            "fax_number": "352-329-1810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 Broadway",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "34741",
            "country_code": "US",
            "telephone_number": "407-846-8180",
            "fax_number": "407-201-7966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KERON",
        "middle_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME94429",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME94429",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME94429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.