John D Ferris, MD
Individual provider Active NPI General Practice Physician · Riverton, WY
NPI 1447439872 · NPPES record last updated Nov 1, 2007
Key facts
- NPI
- 1447439872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 2139A (WY)
- Practice address
- 300 N Broadway Ave
Riverton, WY 82501-3545 - Phone
- (307) 856-0009
- NPI assigned
- Nov 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26101 | CO | MD | General Practice Physician |
| 2139A | WY | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 2139A | WY | Yes |
| General Practice Physician | 208D00000X | 26101 | CO |
Addresses
Primary practice location
300 N Broadway Ave
Riverton, WY 82501-3545
Mailing address
300 N Broadway Ave
Riverton, WY 82501-3545
Phone (307) 856-0009
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89334841 | Medicaid | CO | |
| 91021394 | Medicaid | CO | |
| 0000563350 | Other | KS | BC BS OF KS |
| 830236758012 | Other | WI | BCBS UNITED OF WISCONSIN |
Other providers in Riverton, WY
- Penny Fahey
- Jessica Rae Fahsholtz
- Vicki Morrison Farris
- Jonathan L Faubion
- Alli Jo Ferris
- Shawna Fife
- Stormy Filson
- Bobbie Finn
- Michael R Fisher
- Lars Michael Flanagan
All providers in Riverton, WY · General Practice Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.