Jalen Ferguson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104557937 Issued in VA

Practice address

3526 S Broadway Ave
Tyler, TX 75701-8707

Phone

(678) 761-3497

NPI assigned

Sep 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1376322677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 PREAKNESS DR",
            "city": "FLINT",
            "state": "TX",
            "postal_code": "757626313",
            "telephone_number": "678-761-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018707",
            "telephone_number": "678-761-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JALEN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "VA",
            "license": "0104557937",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104557937",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Elise Fenton, NP
• Robert Fenton, FNP-C
• Deidre Lynn Fergason, OTR
• Chujunna Yovette Ferguson
• Deborah Ferguson
• Laura Ferguson, MD
• Davi Fernandes de Castro, M.D.
• Abigail Ginamarie Fernandez, MA, BCBA
• Gonzalo Fernandez
• Luis G Fernandez, MD

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.