Susan Rene Ferguson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9106360 Issued in FL

Practice address

141 Mack Bayou Loop Ste 101
Santa Rosa Beach, FL 32459-7194

Phone

(850) 863-5990

Fax

(850) 862-0041

NPI assigned

Jul 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carilion Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment NPD
• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472
  Medicare reassignment NPD
• Gastroenterology Consultants of

  • Gastroenterology Physician
  • Roanoke, VA
  • NPI 1417993833
  Medicare reassignment
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD
• Carilion Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1659635829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417A RACETRACK RD NW STE 2",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474604",
            "telephone_number": "850-863-5990",
            "fax_number": "850-862-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MACK BAYOU LOOP STE 101",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597194",
            "telephone_number": "850-863-5990",
            "fax_number": "850-862-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "SUSAN",
        "middle_name": "RENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9106360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Andrew Farnham, M.S., CCC-SLP
• Jennifer Lynn Farris, P.T.
• Christopher Paul Farrugia, DDS
• Mallory Faust
• Jacob Michael Feagans, MD
• David James Ferner, M.D.
• Footseas Medical Inc
• David Michael Franceschini, LPCC (CA), LMHC (FL)
• James Frantz, OT
• Lisa Free, HIS

• Medical Physician Assistant in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.