Brady Robert Fergola, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CR2589 Issued in ME

Practice address

18 West St
Boothbay Harbor, ME 04538-1849

Phone

(207) 633-5500

Fax

(207) 633-0805

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Mid-Coast Spine & Sport

  • Chiropractor
  • Boothbay, ME
  • NPI 1669052601
  Medicare reassignment NPD Authorized official
• Mid-Coast Spine & Sport LLC

  • Chiropractor
  • Boothbay Harbor, ME
  • NPI 1851953475
  NPD Authorized official

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1982263976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MARDEN RD",
            "city": "BOOTHBAY",
            "state": "ME",
            "postal_code": "045375126",
            "telephone_number": "207-357-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WEST ST",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045381849",
            "telephone_number": "207-633-5500",
            "fax_number": "207-633-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGOLA",
        "first_name": "BRADY",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Elbridge Cook, M.D.
• Stuart N Damon, D.O.
• Dr John F Andrews Jr DMD
• Elizabeth Julia Drury, NP
• Emily Erpenbeck, PHARMD
• Cathy Elaine Fisher
• Sharon I Forney, LMT
• Carmen Fortin, CNP
• Jennifer B. Frost, LMSW-CC
• Garth a Miller MD PA

• Chiropractor in Boothbay Harbor, ME
• Providers in Boothbay Harbor, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.