Active NPI
Amber Jane Ferguson, RD
- Registered Dietitian
- St Louis Park, MN
National Provider Identifier
1427202092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2109
- Practice address
- 3525 Monterey Dr
St Louis Park, MN 55416-5275 - Phone
- (952) 993-6200
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2109 | WI | Primary |
Addresses
Primary practice location
3525 Monterey Dr
St Louis Park, MN 55416-5275
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other names 1
- Amber Jane Bowe
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3111 | MN | MD | Optometrist |
| 2109 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
3525 Monterey Dr
St Louis Park, MN 55416
Phone (952) 993-1990
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1912315144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1427202092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 MONTEREY DR",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554165275",
"telephone_number": "952-993-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "AMBER",
"middle_name": "JANE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMBER",
"last_name": "BOWE",
"middle_name": "JANE",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.