Diane A Ferguson, MD
Individual provider Active NPI Family Medicine Physician · Horn Lake, MS
NPI 1265525331 · NPPES record last updated May 4, 2016
Key facts
- NPI
- 1265525331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 10806 (MS)
- Practice address
- 2085 Goodman Rd W
Suite 50
Horn Lake, MS 38637-1416 - Phone
- (662) 253-8459
- Fax
- (662) 253-8678
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sandk Medical,LLC
Practice addresses (Care Compare)
2085 Goodman Rd W
Horn Lake, MS 38637-1416
Phone (662) 253-8459
Hospital & facility affiliations
- Baptist Home Care and Hospice North Mississippi
- Accentcare Home Health of Greenwood
- Baptist Memorial Hospital Desoto
- Methodist Healthcare - Olive Branch Hospital
- Baptist Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081003000687 | MS | Practitioner - Family Practice | 1850469867 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S&K Medical,LLC | Family Medicine | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10806 | MS | Yes |
Addresses
Primary practice location
2085 Goodman Rd W
Suite 50
Horn Lake, MS 38637-1416
Mailing address
2085 Goodman Rd W
Suite 50
Horn Lake, MS 38637-1416
Phone (662) 253-8459
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0111871 | Medicaid | MS |
Other providers in Horn Lake, MS
- Tyshianna B Edwards
- Lanique Ervin
- Essential Health & Wellness Clinic P.a.
- Jenna Evers
- Family & Urgent Care Clinic
- Robert Paul Franco
- Megan Galloway
- Paula Evette Geeter
- Annette Glenn
- Latonya Goliday
All providers in Horn Lake, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.