Individual provider Active NPI

Danielle Kathleen Ferguson, PHYSICAL THERAPIST

  • Physical Therapist
  • Colton, CA
National Provider Identifier
1316617673
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301031 Issued in CA
Practice address
930 S Mount Vernon Ave Ste 400
Colton, CA 92324-3928
Phone
(909) 883-5069
NPI assigned
Sep 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 301031 CA Primary

Addresses

Primary practice location

930 S Mount Vernon Ave Ste 400
Colton, CA 92324-3928

Mailing address

PO Box 10016
Redlands, CA 92375-3216
Phone (909) 883-5069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211206000574 CA Practitioner - Physical Therapist in Private Practice 6406246545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301031CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Physical Therapy Inc. CurrentSince Oct 1, 2021 Accepting new patients

Locations

930 S Mount Vernon Ave
Ste 400
Colton, CA 92324
Phone (909) 370-3396

12139 Mount Vernon Ave
Ste 110
Grand Terrace, CA 92313
Phone (909) 370-3396

1323 W Colton Ave
Ste 105
Redlands, CA 92374
Phone (909) 936-9202

1181 E Highland Ave
#B
San Bernardino, CA 92404
Phone (909) 883-5069

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1316617673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10016",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923753216",
            "telephone_number": "909-883-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S MOUNT VERNON AVE STE 400",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243928",
            "telephone_number": "909-883-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "DANIELLE",
        "middle_name": "KATHLEEN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.