NPIMap

Individual provider Active NPI

Christina Pelton Fergus, M.D.

  • Family Medicine Physician
  • Pulaski, WI
National Provider Identifier
1306977525
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49140 Issued in WI
Practice address
940 S Saint Augustine St
Pulaski, WI 54162-9453
Phone
(920) 822-5444
NPI assigned
Mar 8, 2007
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49140 WI Primary

Addresses

Primary practice location

940 S Saint Augustine St
Pulaski, WI 54162-9453

Mailing address

940 S Saint Augustine St
Pulaski, WI 54162-9453
Phone (920) 822-5444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080816000018 WI Practitioner - Family Practice 8325113939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

940 S Saint Augustine St
Pulaski, WI 54162-9453
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49140WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2009 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Family Medicine Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2020 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine CurrentSince Aug 1, 2009 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Oct 2, 2008 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2020 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Oct 2, 2008 Accepting new patients
Prevea Regional Services, Inc. Family Medicine Past Accepting new patients

Locations

1715 Dousman St
Green Bay, WI 54303

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

940 S Saint Augustine St
Pulaski, WI 54162
Phone (920) 272-1611

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 8

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 7

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1306977525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 S SAINT AUGUSTINE ST",
            "city": "PULASKI",
            "state": "WI",
            "postal_code": "541629453",
            "telephone_number": "920-822-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 S SAINT AUGUSTINE ST",
            "city": "PULASKI",
            "state": "WI",
            "postal_code": "541629453",
            "telephone_number": "920-822-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUS",
        "first_name": "CHRISTINA",
        "middle_name": "PELTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "49140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, WI

Sources for this page

Verify at the official NPI Registry.