Mark Edward Ferguson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008331 Issued in IL

Practice address

3300 Godfrey Rd
Godfrey, IL 62035-2558

Phone

(618) 466-8787

Fax

(618) 466-4703

NPI assigned

Mar 9, 2007

Last updated

Sep 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rose Optical, Inc.Group PAC ID 2961586805, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rose Optical, Inc.

  • Optometrist
  • Godfrey, IL
  • NPI 1669444063
  Medicare reassignment Care Compare group NPD
• Illini Optometric PC

  • Optometrist
  • Godfrey, IL
  • NPI 1780850032
  Authorized official Same address or phone

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1598897456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 KINGSLEY WAY",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341548",
            "telephone_number": "618-288-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GODFREY RD",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352558",
            "telephone_number": "618-466-8787",
            "fax_number": "618-466-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008331",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucas Edwards
• Tracie Lynn Eilerman, FNP
• Mary E Elliott
• Carol J Feldewerth, PTA
• Callie Ann Feldman
• Lori Lynn Ford, SLP
• Allison Chelsea Fowler, OTR/L
• Maura Fredrick, M.S. CCC-SLP
• Valerie Ann Fretz, NP
• Shawtika Gardner

• Optometrist in Godfrey, IL
• Providers in Godfrey, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.