Active NPI
Bonny F. Ferguson, CRNA
- Certified Registered Nurse Anesthetist
- Charleston, SC
National Provider Identifier
1710264478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 17689
- Practice address
- 9263 Medical Plaza Dr.
Ste E
Charleston, SC 29406-7112 - Phone
- (843) 572-1228
- Fax
- (877) 561-7564
- NPI assigned
- Nov 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 78227 | SC | |
| Certified Registered Nurse Anesthetist | 367500000X | 17689 | SC | Primary |
Addresses
Primary practice location
9263 Medical Plaza Dr.
Ste E
Charleston, SC 29406-7112
Mailing address
9263 Medical Plaza Dr.
Ste E
Charleston, SC 29406-7112
Phone (843) 572-1228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AN2186 | Medicaid | SC |
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
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78227 | SC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Anesthesia, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Charleston, SC
- NPI 1992943484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338508800000",
"number": "1710264478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9263 MEDICAL PLAZA DR.",
"address_2": "STE E",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294067112",
"telephone_number": "843-572-1228",
"fax_number": "877-561-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9263 MEDICAL PLAZA DR.",
"address_2": "STE E",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294067112",
"telephone_number": "843-572-1228",
"fax_number": "877-561-7564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "BONNY",
"middle_name": "F.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-09",
"last_updated": "2012-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "78227",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "17689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AN2186",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.