NPIMap

Individual provider Active NPI

Vincent Ferguson, MD

  • Emergency Medicine Physician
  • Hartwell, GA
National Provider Identifier
1770516684
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
37203 Issued in GA
Practice address
138 W Gibson St
Hartwell, GA 30643-1847
Phone
(904) 805-1300
Fax
(904) 805-1302
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37203 GA Primary

Addresses

Primary practice location

138 W Gibson St
Hartwell, GA 30643-1847

Mailing address

PO Box 532723
Atlanta, GA 30353-2723
Phone (904) 805-1300

Other identifiers 2

IdentifierTypeStateIssuer
007073OtherGABLUE CROSS
G37203MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417000712 GA Practitioner - Emergency Medicine 5294713715

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Meharry Medical College School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanuel County Hospital AuthorityGroup PAC ID 3577473040, 40 clinicians

Practice addresses (Care Compare)

120 A Victory Dr
Swainsboro, GA 30401-3235
Phone (478) 237-3291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37203GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Hartwell Emergency Services, LLC Emergency Medicine Past Accepting new patients
Ohoopee River Emergency Physicians Emergency Medicine Past Accepting new patients
Carter Emergency Physicians Emergency Medicine Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Burke Emergency Physicians Emergency Medicine Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hands of Grace Hospice LLCAugusta, GA, CCN 851507 Hospice Contracted Managing Employee (0.25%) Jan 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770516684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303532723",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W GIBSON ST",
            "city": "HARTWELL",
            "state": "GA",
            "postal_code": "306431847",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "37203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "007073",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G37203",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartwell, GA

Sources for this page

Verify at the official NPI Registry.