Individual provider Active NPI

Erin K Ferguson, NP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1649437617
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN115235 Issued in AZ
Practice address
4444 N 32ND St
Suite 175
Phoenix, AZ 85018-3956
Phone
(602) 952-0002
Fax
(602) 778-4565
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN115235 AZ Primary

Addresses

Primary practice location

4444 N 32ND St
Suite 175
Phoenix, AZ 85018-3956

Mailing address

4444 N 32ND St
Suite 175
Phoenix, AZ 85018-3956
Phone (602) 952-0002

Other identifiers 1

IdentifierTypeStateIssuer
RN115235OtherAZRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091016000227 AZ Practitioner - Nurse Practitioner 6002962495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Super Specialists LLCGroup PAC ID 1850695255, 31 clinicians
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN115235AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Super Specialists LLC CurrentSince Dec 1, 2017 Accepting new patients

Locations

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

Organizations & group practices 1

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 1

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1649437617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 N 32ND ST",
            "address_2": "SUITE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183956",
            "telephone_number": "602-952-0002",
            "fax_number": "602-778-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 N 32ND ST",
            "address_2": "SUITE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183956",
            "telephone_number": "602-952-0002",
            "fax_number": "602-778-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ERIN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN115235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN115235",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.