Active NPI
Jared Ferguson
- Nutritionist
- North Wales, PA
National Provider Identifier
1790299022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- DN0063
- Practice address
- 1304 Morris CT
North Wales, PA 19454-1050 - Phone
- (267) 546-6659
- NPI assigned
- Nov 22, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | DN0063 | PA | Primary |
Addresses
Primary practice location
1304 Morris CT
North Wales, PA 19454-1050
Mailing address
1280 Anders Rd
Lansdale, PA 19446-4845
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0063 | PA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511308800000",
"number": "1790299022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1280 ANDERS RD",
"city": "LANSDALE",
"state": "PA",
"postal_code": "194464845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 MORRIS CT",
"city": "NORTH WALES",
"state": "PA",
"postal_code": "194541050",
"telephone_number": "267-546-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "JARED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-22",
"last_updated": "2017-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PA",
"license": "DN0063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Wales, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.