Individual provider Active NPI

Kristian M Ferry, MD

  • Surgery Physician
  • Eugene, OR
National Provider Identifier
1629056148
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD22878 Issued in OR
Practice address
360 S Garden Way
Ste 290
Eugene, OR 97401-8173
Phone
(541) 345-2205
Fax
(541) 345-4480
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD22878 OR Primary

Addresses

Primary practice location

360 S Garden Way
Ste 290
Eugene, OR 97401-8173

Mailing address

PO Box 1648
Eugene, OR 97440-1648
Phone (541) 687-4900

Other identifiers 1

IdentifierTypeStateIssuer
287410MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000569 OR Practitioner - General Surgery 6709866304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22878ORMDSurgery Physician
22878ORMDMassage Therapist

Interoperability endpoints

  • Direct secure messaging: ferrykm@yourcarecommunity.org

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1629056148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-687-4900",
            "fax_number": "541-242-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY",
            "address_2": "STE 290",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018173",
            "telephone_number": "541-345-2205",
            "fax_number": "541-345-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRY",
        "first_name": "KRISTIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD22878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287410",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.