Kevin John Ferguson, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704218229 Issued in MI

Practice address

955 S Bailey Ave
South Haven, MI 49090-6743

Phone

(269) 639-5271

NPI assigned

Jul 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

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 and National Provider Directory roles.

• Bronson South Haven Hospital

  • Family Medicine Physician
  • South Haven, MI
  • NPI 1174749170
  Medicare reassignment NPD
• Bronson South Haven Hospital

  • General Acute Care Hospital
  • South Haven, MI
  • NPI 1346275856
  NPD

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

{
    "created_epoch": "1184976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1407056013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-639-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-639-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-21",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704218229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407056013",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Birgit Erickson
• Birdie Farley
• Karrie Farley
• Trisha Lynn Farrell, CNM, WHNP, MS
• Katherine Feig
• Amy Flessner, RN
• Lisa Ellen Follman
• Michele Patricia Fontaine, RN
• Paul Frederick
• Friends Who Care-South Haven,LLC

• Nurse Practitioner in South Haven, MI
• Providers in South Haven, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.