Individual provider Active NPI

Yvonne D Fergusonhardin, BS, MFS,GFI

  • Athletic Trainer
  • Phila, PA
National Provider Identifier
1588367767
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2255A2300X Issued in PA
Practice address
47 E High St
Phila, PA 19144-2116
Phone
(973) 922-3794
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X 2255A2300X PA Primary

Addresses

Primary practice location

47 E High St
Phila, PA 19144-2116

Mailing address

164 W Hortter St
Phila, PA 19119-2706
Phone (973) 922-3794

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)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2255A2300XPAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1588367767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W HORTTER ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191192706",
            "telephone_number": "973-922-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 E HIGH ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191442116",
            "telephone_number": "973-922-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSONHARDIN",
        "first_name": "YVONNE",
        "middle_name": "D",
        "name_prefix": "Miss",
        "credential": "BS, MFS,GFI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "2255A2300X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.