Individual provider Active NPI

Tabitha Nicole Ferguson, LICSW

  • Clinical Social Worker
  • Madison, AL
National Provider Identifier
1821633728
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4379C Issued in AL
Practice address
600 Sun Temple Dr
Madison, AL 35758-8643
Phone
(256) 288-3333
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4379C AL Primary

Addresses

Primary practice location

600 Sun Temple Dr
Madison, AL 35758-8643

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 288-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428001315 TN Practitioner - Clinical Social Worker 9830525922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians
Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

482 Interstate Dr
Manchester, TN 37355-3109
Phone (931) 728-4718

606 N Broad St
New Tazewell, TN 37825-6610
Phone (423) 259-5002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4379CALMDClinical Social Worker
7281TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ultacare Medical PLLC Clinical CurrentSince Mar 14, 2020 Accepting new patients
Elite Urgent Care PLLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

287 Baker St
Huntsville, TN 37756
Phone (212) 595-0005

1225 E Weisgarber Rd
Ste 190
Knoxville, TN 37909
Phone (423) 259-5002

606 N Broad St
New Tazewell, TN 37825
Phone (423) 626-0466

5261 Carrollton Pike
Ste A
Woodlawn, VA 24381

5261 Carrollton Pike
Ste C
Woodlawn, VA 24381
Phone (276) 238-0911

Organizations & group practices 3

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1821633728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-288-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "TABITHA",
        "middle_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4379C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.