Atlantic Nephrology Inc
Organization Active NPI Nephrology Physician · Flagler Beach, FL
NPI 1376704155 · NPPES record last updated Sep 15, 2025
Key facts
- NPI
- 1376704155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- ME94793 (FL)
- Legal business name
- ATLANTIC NEPHROLOGY INC
- Practice address
- 210 Old Kings Rd S Ste 900
Flagler Beach, FL 32136-4380 - Phone
- (383) 338-3550
- Fax
- (386) 338-3551
- NPI assigned
- Jun 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. William Bonlore Ferguson, MD, PHD
- Title
- President/Owner
- Phone
- (386) 871-3767
Practitioners 2
-
William Bonlore Ferguson, PHD, MD
-
Becki D Melton, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081231000510 | FL | Part B Supplier - Clinic/Group Practice | 4688736580 |
Receives reassigned benefits from 2 practitioners Practice locations: Flagler Beach, FL |
National Provider Directory
Locations
210 Old Kings Rd S
Ste 900
Flagler Beach, FL 32136
Phone (383) 338-3550
14 Kingswood Dr
Palm Coast, FL 32137
61 Memorial Medical Pkwy
Ste 3806
Palm Coast, FL 32164
Phone (386) 437-7340
13 Kingswood Dr
Palm Coast, FL 32137
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician |
207RN0300X | ME94793 | FL | Yes |
Addresses
Primary practice location
210 Old Kings Rd S Ste 900
Flagler Beach, FL 32136-4380
Mailing address
210 Old Kings Rd S Ste 900
Flagler Beach, FL 32136-4380
Phone (386) 338-3550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000159300 | Medicaid | FL | |
| AD824Z | Other | FL | PTAN |
| 250792700 | Medicaid | FL | |
| 40336 | Other | FL | MEDICARE NUMBER |
Other providers in Flagler Beach, FL
- Lisa Marie Adams
- Robin Beaty Adams
- Thomas Avent Adams
- Kristine Aguirre
- Analex of Flagler Beach, Inc.
- Back in Action Chiropractic of FL
- Back in Action Chiropractors Co. Inc
- Beatrice Borges
- Carol Ruth Brown
- Long Phi Bui
All providers in Flagler Beach, FL · Nephrology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.