Individual provider Active NPI

Bruce Allen Ferrell, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Encino, CA
National Provider Identifier
1487689121
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
G60156 Issued in CA
Practice address
1683 Ventura Blvd
Encino, CA 91436-1707
Phone
(310) 825-0631
Fax
(310) 794-2113
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X G60156 CA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X G60156 CA Primary

Addresses

Primary practice location

1683 Ventura Blvd
Encino, CA 91436-1707

Mailing address

16830 Ventura Blvd
Encino, CA 91436-1707
Phone (818) 385-0273

Other identifiers 1

IdentifierTypeStateIssuer
00G601560MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60156CAMDGeneral Practice Dentistry
G60156CAMDHospice and Palliative Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487689121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16830 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361707",
            "telephone_number": "818-385-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361707",
            "telephone_number": "310-825-0631",
            "fax_number": "310-794-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "BRUCE",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G60156",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "G60156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G601560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.