Individual provider Active NPI

Robert C Ferguson, M.D.

  • Cardiovascular Disease Physician
  • Gainesville, GA
National Provider Identifier
1669475810
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
15667 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501-3861
Phone
(770) 536-9864
Fax
(770) 297-5023
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 15667 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501-3861

Mailing address

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone (770) 536-9864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Diagnostic Clinic LLC Current Accepting new patients
Gwinnett Dermatology PC D/B/a Georgia Dermatology Partners Past Accepting new patients

Locations

1515 River Pl
Ste 360
Braselton, GA 30517
Phone (770) 965-2022

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1669475810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "STE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "15667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.