Active NPI
Carol D Ferguson, PT
- Physical Therapist
- Lakewood, WA
National Provider Identifier
1457367377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00001089
- Practice address
- 11307 Bridgeport Way SW
Ste 220
Lakewood, WA 98499-3024 - Phone
- (253) 985-2733
- Fax
- (253) 985-2868
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00001089 | WA | Primary |
Addresses
Primary practice location
11307 Bridgeport Way SW
Ste 220
Lakewood, WA 98499-3024
Mailing address
11307 Bridgeport Way SW
Ste 220
Lakewood, WA 98499-3024
Phone (253) 985-2733
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8420549 | Medicaid | WA | |
| 0195036 | Other | WA | L & I |
| 8904774 | Other | WA | CRIME VICTIMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203638400000",
"number": "1457367377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11307 BRIDGEPORT WAY SW",
"address_2": "STE 220",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993024",
"telephone_number": "253-985-2733",
"fax_number": "253-985-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11307 BRIDGEPORT WAY SW",
"address_2": "STE 220",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993024",
"telephone_number": "253-985-2733",
"fax_number": "253-985-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "CAROL",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2008-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00001089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8420549",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I",
"identifier": "0195036",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8904774",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.