Individual provider Active NPI

Michael Hans Ferguson, P.A.

  • Physician Assistant
  • Murray, UT
National Provider Identifier
1982629200
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2152121206 Issued in UT
Practice address
5169 S Cottonwood St Ste 600
Murray, UT 84107-6771
Phone
(801) 507-3600
Fax
(801) 507-3625
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2152121206 UT Primary

Addresses

Primary practice location

5169 S Cottonwood St Ste 600
Murray, UT 84107-6771

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

324 10th Ave Ste 154
Salt Lake City, UT 84103-2876
Phone (801) 408-8666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061227000129 UT Practitioner - Physician Assistant 5799785697 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2152121206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 24, 2002 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 24, 2002 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5169 S Cottonwood St
Ste 600
Salt Lake City, UT 84107
Phone (801) 507-3600

324 Tenth Ave
Ste 154
Salt Lake Cty, UT 84103
Phone (801) 408-8500

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1982629200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5169 S COTTONWOOD ST STE 600",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076771",
            "telephone_number": "801-507-3600",
            "fax_number": "801-507-3625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 10th Ave Ste 154",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841032876",
            "country_code": "US",
            "telephone_number": "801-408-8666",
            "fax_number": "801-322-0567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "MICHAEL",
        "middle_name": "HANS",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "2152121206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.