Chante Nicole Ferguson
Individual provider Active NPI Family Nurse Practitioner · Taylorsville, MS
NPI 1568074151 · NPPES record last updated Nov 30, 2021
Key facts
- NPI
- 1568074151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 894623 (MS)
- Practice address
- 403 Pine St
Taylorsville, MS 39168-5659 - Phone
- (601) 452-7080
- Fax
- (601) 452-7083
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Petal Urgent Care LLC
Ocean Springs Urgent Care
Mississippi Medical Clinic of Mendehall
Practice addresses (Care Compare)
1272 Evelyn Gandy Pkwy
Suite 60
Petal, MS 39465-3953
Phone (601) 336-5393
1514 Bienville Blvd
Ocean Springs, MS 39564-3006
Phone (228) 382-9222
2170 Simpson Hwy 49
Mendenhall, MS 39114-5418
Phone (601) 675-1200
Hospital & facility affiliations
- Simpson General Hospital Cah
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220517000261 | MS | Practitioner - Nurse Practitioner | 8224435680 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 894623 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Springs Urgent Care | Current |
Accepting new patients | |
| Mississippi Medical Clinic of Mendehall | Current |
Accepting new patients | |
| Petal Urgent Care LLC | Current |
Accepting new patients | |
| Mississippi Medical Clinic | Family | Current |
Accepting new patients |
Locations
1514 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 382-9222
1272 Evelyn Gandy Pkwy
Ste 60
Petal, MS 39465
Phone (601) 336-5393
403 Pine St
Taylorsville, MS 39168
Phone (601) 452-7080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Nurse Practitioner | 363LF0000X | 894623 | MS | Yes |
Addresses
Primary practice location
403 Pine St
Taylorsville, MS 39168-5659
Mailing address
403 Pine St
Taylorsville, MS 39168-5659
Phone (601) 452-7080
Other providers in Taylorsville, MS
- Divine Behavioral Solutions
- Lawanda Nicole Ellis
- Family Health Care Clinic, Inc
- Family Health Care Clinic, Inc
- Family Health Center, Inc
- Freds Xpress
- John R. Harper
- Hattiesburg Clinic PA
- Lynwood Hightower
- Amanda Jacobs
All providers in Taylorsville, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.