Kimela J Ferguson, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R161985 Issued in MD

Practice address

4604 York Rd
Baltimore, MD 21212-4726

Phone

(443) 802-5130

NPI assigned

Apr 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Malama Medical

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1659929487
  Medicare reassignment NPD Authorized official
• Malama Medical

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rosedale, MD
  • NPI 1942159850
  NPD (past) Authorized official
• Malama Medical, LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Baltimore, MD
  • NPI 1023775830
  Authorized official Same address or phone
• Malama Medical, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rosedale, MD
  • NPI 1326908070
  NPD (past) Authorized official
• Body Image Therapy Center Intensive

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1982035994
  NPD (past)

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1336637602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 YORK CT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212181248",
            "telephone_number": "443-802-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124726",
            "telephone_number": "443-802-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KIMELA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R161985",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1027130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Ferguson, LCSW-C
• Johneese Ferguson
• Julie Scavnicky Ferguson, MS, CCC-SLP
• Juliet Ferguson
• Katherine P Ferguson, CCC-SLP
• Meaghan Ferguson, LMSW
• Sherlema Ferguson, LCSW-C
• Taylor Marie Ferguson
• Travis Ferguson
• Janice Ferlitch, CRNP

• Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.