Individual provider Active NPI

Ana Marie Ferguson, FNP-C

  • Family Nurse Practitioner
  • Myrtle Point, OR
National Provider Identifier
1720407786
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201400072NP-PP Issued in OR
Practice address
324 4TH St
Myrtle Point, OR 97458
Phone
(541) 572-2111
Fax
(541) 572-5743
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201400072NP-PP OR Primary

Addresses

Primary practice location

324 4TH St
Myrtle Point, OR 97458

Mailing address

324 4TH St
Myrtle Point, OR 97458
Phone (541) 572-2111

Other identifiers 5

IdentifierTypeStateIssuer
500675277MedicaidOR
R0000WFBTVOtherORNORTH BEND MEDICAL CENTER GROUP MEDICARE
161133OtherORNORTH BEND MEDICAL CENTER GROUP MEDICAID
P01805331OtherORRAILROAD MEDICARE
1407812365OtherORNORTH BEND MEDICAL CENTER GROUP NPI

Other names 1

  • Mrs. Ana Marie Victoria Ferguson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20141031000000 OR Practitioner - Nurse Practitioner 1153542360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Bend Medical Center IncGroup PAC ID 5597677716, 92 clinicians

Practice addresses (Care Compare)

324 4TH St
Myrtle Point, OR 97458-1066
Phone (541) 572-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201400072NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Aug 1, 2014 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Aug 1, 2014 Accepting new patients
North Bend Medical Center Inc CurrentSince Sep 15, 2016 Accepting new patients
North Bend Medical Center Inc Past Accepting new patients

Locations

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

324 4th St
Myrtle Point, OR 97458
Phone (541) 572-2111

Interoperability endpoints

  • Direct secure messaging: aferguson124467@secure.stcharleshealthcare.org

Organizations & group practices 4

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.

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1720407786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 4TH ST",
            "city": "MYRTLE POINT",
            "state": "OR",
            "postal_code": "97458",
            "telephone_number": "541-572-2111",
            "fax_number": "541-572-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 4TH ST",
            "city": "MYRTLE POINT",
            "state": "OR",
            "postal_code": "97458",
            "telephone_number": "541-572-2111",
            "fax_number": "541-572-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "ANA MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201400072NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500675277",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICARE",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICAID",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01805331",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP NPI",
            "identifier": "1407812365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA MARIE",
            "last_name": "FERGUSON",
            "middle_name": "VICTORIA",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Myrtle Point, OR

Sources for this page

Verify at the official NPI Registry.