Individual provider Active NPI

Patricia Anne Ferguson-Wilcox, M.D.

  • Psychiatry Physician
  • Grants Pass, OR
National Provider Identifier
1346354016
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD23467 Issued in OR
Practice address
1181 Ramsey Ave
Grants Pass, OR 97527-5821
Phone
(541) 476-2373
Fax
(541) 476-1526
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD23467 OR Primary

Addresses

Primary practice location

1181 Ramsey Ave
Grants Pass, OR 97527-5821

Mailing address

1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373

Other identifiers 2

IdentifierTypeStateIssuer
209973MedicaidOR
096818MedicaidOR

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD23467ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Options for Southern Oregon Past Accepting new patients
Josephine County Past Accepting new patients
Options for Southern Oregon Past Accepting new patients

Organizations & group practices 3

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346354016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373",
            "fax_number": "541-476-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275821",
            "telephone_number": "541-476-2373",
            "fax_number": "541-476-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON-WILCOX",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD23467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209973",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096818",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.