NPIMap

Individual provider Active NPI

Susan Portis Ferguson, M.D.

  • Family Medicine Physician
  • Lincoln, AR
National Provider Identifier
1609989250
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0942 Issued in AR
Practice address
106 E Park St
Lincoln, AR 72744-8706
Phone
(479) 267-2120
NPI assigned
Aug 17, 2006
Last updated
Jun 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E0942 AR Primary

Addresses

Primary practice location

106 E Park St
Lincoln, AR 72744-8706

Mailing address

PO Box 800
Lincoln, AR 72744-0810

Other identifiers 2

IdentifierTypeStateIssuer
131505001MedicaidAR
080127088OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928001405 AR Practitioner - Family Practice 2567497514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

106 E Park St
West Washington County Clinic Washington Re
Lincoln, AR 72744-8706
Phone (479) 267-2120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0942ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Family Medicine Current Accepting new patients
Washington Regional Medical System Family Medicine CurrentSince Jun 20, 2018 Accepting new patients
Washington Regional Medical System Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Farmington Family Medical LLC Family Medicine PastSince Aug 13, 2021 Accepting new patients

Locations

114 E Sunbridge Dr
#J
Fayetteville, AR 72703
Phone (479) 463-2597

106 E Park St
Lincoln, AR 72744
Phone (479) 267-2120

Interoperability endpoints

  • Direct secure messaging: sferguson28893@washingtonregional.direct-ci.com
  • Direct secure messaging: susanferguson@wrms.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1609989250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "city": "LINCOLN",
            "state": "AR",
            "postal_code": "727440810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E PARK ST",
            "city": "LINCOLN",
            "state": "AR",
            "postal_code": "727448706",
            "telephone_number": "479-267-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "SUSAN",
        "middle_name": "PORTIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131505001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080127088",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, AR

Sources for this page

Verify at the official NPI Registry.