Individual provider Active NPI

Jeffrey Scott Fergerson, MPT

  • Physical Therapist
  • South Burlington, VT
National Provider Identifier
1841397429
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040-0003606 Issued in VT
Practice address
192 Tilley Dr
South Burlington, VT 05403-4440
Phone
(802) 847-7115
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 040.0003606 VT
Physical Therapist 225100000X 040-0003606 VT Primary

Addresses

Primary practice location

192 Tilley Dr
South Burlington, VT 05403-4440

Mailing address

192 Tilley Dr
South Burlington, VT 05403-4440
Phone (802) 847-7115

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other practice location 2

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

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

LicenseStateTypeSpecialty
040.0003606VTMDSports Medicine (Physical Medicine & Rehabilitation) Physician
040-0003606VTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1841397429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-7115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGERSON",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VT",
            "license": "040.0003606",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0003606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.