Phyllis A Ferguson, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP3001680 Issued in WA

Practice address

9416 271St St NW
Stanwood, WA 98292-8094

Phone

(425) 820-2440

NPI assigned

Sep 14, 2006

Last updated

Jun 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Phillis Annette Shaver Other name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Phyllis a. Ferguson Arnp MSN Inc PS

  • Nurse Practitioner
  • Kirkland, WA
  • NPI 1346496080
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1659476505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2718",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982922718",
            "telephone_number": "425-820-2440",
            "fax_number": "425-820-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9416 271ST ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982928094",
            "telephone_number": "425-820-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11415 NE 128th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980346314",
            "country_code": "US",
            "telephone_number": "425-820-2440",
            "fax_number": "425-820-8616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "PHYLLIS",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP3001680",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP3001680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLIS",
            "last_name": "SHAVER",
            "middle_name": "ANNETTE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eyecare Northwest Inc PS (Stanwood Vision)
• Joy R Fackenthall, MD
• Autumn Vivienne Falk-O'Denius, LAC LMP
• Brandon Jayson Falk, D.C.
• Bambe Gassama Fatty
• Cody E Finks, DPT
• Alexandra Catherine Marie Fiola
• Jennifer Fisher
• Janae Gwen Fletcher, LMT
• Bambie Fontana, RN

• Psychiatric/Mental Health Nurse Practitioner in Stanwood, WA
• Providers in Stanwood, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.