Individual provider Active NPI

Adam Ferguson

  • Student in an Organized Health Care Education/Training Program
  • Morgantown, WV
National Provider Identifier
1265734412
Registry record updated Nov 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
IN0006592 Issued in WV
Practice address
311 Creekside Dr
Morgantown, WV 26508-9099
Phone
(304) 241-1279
NPI assigned
Nov 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IN0006592 WV Primary

Addresses

Primary practice location

311 Creekside Dr
Morgantown, WV 26508-9099

Mailing address

311 Creekside Dr
Morgantown, WV 26508-9099
Phone (304) 241-1279

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
IN0006592WVMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1290211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290211200000",
    "number": "1265734412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 CREEKSIDE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265089099",
            "telephone_number": "304-241-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CREEKSIDE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265089099",
            "telephone_number": "304-241-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-20",
        "last_updated": "2010-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": "IN0006592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2010; 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.