Organization Active NPI

Ferguson Life Health Centers of New Jersey

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Whippany, NJ
National Provider Identifier
1578065728
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
FERGUSON LIFE HEALTH CENTERS OF NEW JERSEY
Practice address
375 Route 10
Whippany, NJ 07981-2115
Phone
(973) 210-3838
Fax
(973) 947-7009
NPI assigned
Mar 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Derek D Ferguson
Title
Owner
Phone
(201) 716-9199

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

375 Route 10
Whippany, NJ 07981-2115

Mailing address

375 Route 10
Whippany, NJ 07981-2115
Phone (973) 210-3838

National Provider Directory

National Provider Directory

Locations

375 Route 10
Whippany, NJ 07981
Phone (973) 210-3838

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1578065728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ROUTE 10",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079812115",
            "telephone_number": "973-210-3838",
            "fax_number": "973-947-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 ROUTE 10",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079812115",
            "telephone_number": "973-210-3838",
            "fax_number": "973-947-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERGUSON LIFE HEALTH CENTERS OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-716-9199"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.