Individual provider Active NPI

Jonathan L. Ferguson, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Rockford, IL
National Provider Identifier
1669452934
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
036078516 Issued in IL
Practice address
698 Featherstone Rd
Rockford, IL 61107-6303
Phone
(815) 398-3277
Fax
(815) 484-7001
NPI assigned
Jan 20, 2006
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 036078516 IL Primary

Addresses

Primary practice location

698 Featherstone Rd
Rockford, IL 61107-6303

Mailing address

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

Other identifiers 1

IdentifierTypeStateIssuer
036078516MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20071022000590 IL Practitioner - Otolaryngology 0840184982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036078516ILMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Featherstone Clinic, S.C. PastSince Jan 16, 2003 Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

698 Featherstone Rd
Rockford, IL 61107
Phone (815) 398-3277

Organizations & group practices 3

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1669452934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076303",
            "telephone_number": "815-398-3277",
            "fax_number": "815-484-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076303",
            "telephone_number": "815-398-3277",
            "fax_number": "815-484-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "JONATHAN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IL",
            "license": "036078516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078516",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.