Cory David Ferguson, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6122 Issued in AZ

Practice address

250 N Litchfield Rd
Ste. 155
Goodyear, AZ 85338-1333

Phone

(623) 882-9787

Fax

(623) 882-9791

NPI assigned

Sep 12, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• White Tanks Physical Therapy and Orthopedic Rehabilitation LLC

  • Specialist
  • Goodyear, AZ
  • NPI 1194808600
  Medicare reassignment NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment
• BHSM Rehabilitation LLC

  • Physical Therapy Clinic/Center
  • Casa Grande, AZ
  • NPI 1679098628
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1497271431
  NPD
• White Tanks Physical Therapy & Ortho Rehab

  • Physical Therapist
  • Goodyear, AZ
  • NPI 1386644599
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1851586804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N LITCHFIELD RD",
            "address_2": "STE. 155",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381333",
            "telephone_number": "623-882-9787",
            "fax_number": "623-882-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N LITCHFIELD RD",
            "address_2": "STE. 155",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381333",
            "telephone_number": "623-882-9787",
            "fax_number": "623-882-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "CORY",
        "middle_name": "DAVID",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6122",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "916190",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00388070",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7499498",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0299850",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASH DEPT OF LABOR",
            "identifier": "0142085",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "64-0096",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "103195",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2Z2985",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "0142085",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE PLAN",
            "identifier": "916190",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Favreau
• Jennifer L Fawcett, OTR/L
• Adam Febles, PT, DPT
• Magdiel Felix Pineda
• Angelina D Fenwick
• Megan Elizabeth Ferguson, PT, DPT, ATC
• Regina Ferguson, SLPA
• Diane Fernandez, M.D.
• Josephine C. Ferretti, RPH
• Jeremy Ficken, NP-C

• Physical Therapist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.