Individual provider Active NPI

Peter J Ferguson, LMSW, ACSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1366455040
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081112 Issued in MI
Practice address
5331 Plymouth Rd
Ann Arbor, MI 48105-9520
Phone
(734) 996-9111
Fax
(734) 996-1950
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801081112 MI Primary

Addresses

Primary practice location

5331 Plymouth Rd
Ann Arbor, MI 48105-9520

Mailing address

2426 Sunny Ridge Dr
Pinckney, MI 48169-9244
Phone (734) 272-7145

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

State licenses

LicenseStateTypeSpecialty
6801081112MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1366455040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 SUNNY RIDGE DR",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481699244",
            "telephone_number": "734-272-7145",
            "fax_number": "734-996-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059520",
            "telephone_number": "734-996-9111",
            "fax_number": "734-996-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; 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.