McKenna Collier Ferguson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA223194 Issued in OR

Practice address

621 W Madrone St
Roseburg, OR 97470-3090

Phone

(541) 440-3532

NPI assigned

Apr 28, 2021

Last updated

Mar 17, 2025By 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 3

Addresses

Other names 1

• McKenna Collier Smith Former name

Medicare fee-for-service enrollment

Enrolled in UT, OR2 enrollments

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 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adapt

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
  • NPI 1720010549
  Medicare reassignment
• Odyssey House Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033143706
  Medicare reassignment
• Adapt

  dba Adapt Integrated Health Care

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1184350811
  NPD
• Adapt

  dba Adapt Integrated Health Care

  • Federally Qualified Health Center (FQHC)
  • Bandon, OR
  • NPI 1194529289
  NPD
• Odyssey House Inc

  dba Odyssey House Martindale Clinic

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1407481245
  NPD
• Adapt

  dba SouthRiver Medical Clinic aka: SouthRiver Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Winston, OR
  • NPI 1912061755
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1679156608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-440-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "MCKENNA",
        "middle_name": "COLLIER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA223194",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "13768000-1206",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENNA",
            "last_name": "SMITH",
            "middle_name": "COLLIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Ashleigh Farnsworth, PHARM.D.
• Samar Azam Farooqui
• Barbara Farrand, LPC
• Faye Ameredes DO PC (Harmony Health for Women)
• Howard J Feldman, MD
• Serena Rose Ferris, PHARMD
• Paul J Fieber, P.A.
• David Tait Finlay, DMD
• Steven C Finlayson, DC
• John R Finney, PH.D.

• Physician Assistant in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.