Individual provider Active NPI

Karen Bockrath Ferguson, D.C.

  • Chiropractor
  • Acworth, GA
National Provider Identifier
1770628422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5420 Issued in GA
Practice address
4609 S Main St
Acworth, GA 30101-5463
Phone
(770) 966-1800
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5420 GA Primary

Addresses

Primary practice location

4609 S Main St
Acworth, GA 30101-5463

Mailing address

1105 Osprey RDG NW
Kennesaw, GA 30152-2836
Phone (770) 919-2555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000303 GA Practitioner - Chiropractic 6901050947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4609 S Main St
Acworth, GA 30101-5463
Phone (770) 966-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5420GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ferguson Family Chiropractic Chiropractor CurrentSince Sep 24, 1996 Accepting new patients
Lotus Chiropractic Care LLC Past Accepting new patients

Locations

4609 S Main St
Acworth, GA 30101
Phone (770) 966-1800

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770628422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 OSPREY RDG NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301522836",
            "telephone_number": "770-919-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 S MAIN ST",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015463",
            "telephone_number": "770-966-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KAREN",
        "middle_name": "BOCKRATH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.