Active NPI
Mark Allen Ferguson, PT
- Physical Therapist
- Fuquay Varina, NC
National Provider Identifier
1265078398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P10692
- Practice address
- 1221 Broad St
Fuquay Varina, NC 27526-3602 - Phone
- (919) 552-4580
- NPI assigned
- Nov 25, 2019
- Last updated
- Nov 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P10692 | NC | Primary |
Addresses
Primary practice location
1221 Broad St
Fuquay Varina, NC 27526-3602
Mailing address
224 Hidden Farm LN
Holly Springs, NC 27540-7493
Phone (919) 579-4679
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
| License | State | Type | Specialty |
|---|---|---|---|
| P10692 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1265078398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 HIDDEN FARM LN",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275407493",
"telephone_number": "919-579-4679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 BROAD ST",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275263602",
"telephone_number": "919-552-4580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "MARK",
"middle_name": "ALLEN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-25",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P10692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.