Organization Active NPI

Robert B Ferguson M.D. P.C.

  • Specialist
  • West Bloomfield, MI
National Provider Identifier
1629339817
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301058431 Issued in MI
Legal business name
ROBERT B FERGUSON M.D. P.C.
Practice address
4256 Orchard Lake Rd
West Bloomfield, MI 48323-1645
Phone
(248) 682-1720
Fax
(248) 682-9289
NPI assigned
Jun 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Dr. Robert Ferguson, M.D.NPI 1174694673
Title
Physician
Phone
(248) 682-1720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301058431 MI Primary

Addresses

Primary practice location

4256 Orchard Lake Rd
West Bloomfield, MI 48323-1645

Mailing address

4256 Orchard Lake Rd
West Bloomfield, MI 48323-1645
Phone (248) 682-1720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121019000307 MI Part B Supplier - Clinic/Group Practice 7113912866 Receives reassigned benefits from 1 practitioner
Practice locations: Waterford, MI; West Bloomfield, MI; Pontiac, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1629339817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231645",
            "telephone_number": "248-682-1720",
            "fax_number": "248-682-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4256 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231645",
            "telephone_number": "248-682-1720",
            "fax_number": "248-682-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B FERGUSON M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "248-682-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301058431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.