TODD S FERGUS (NPI# 1083694111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083694111 |
| Entity Type | Individual |
| Full Name | TODD S FERGUS |
| Credential | MD |
| Practice Address |
1727 Shawano Ave Suite 201 Green Bay WI 54303-3273 |
| Practice Telephone | 9204968877 |
| Practice Fax Number | 9204963061 |
| Mailing Telephone | 9204968877 |
| Mailing Fax Number | 9204963061 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2009-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
47587-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34684700 | 05 | |
| DEA | BF8745373 | 01 | |
| RAILROAD MEDICARE | P00606706 | 01 |
| Street Address |
1727 SHAWANO AVE SUITE 201 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639157936 | Peter Fergus | Internal Medicine | 1727 Shawano Ave, Ste 201, Green Bay, WI 54303-3273 | 2006-01-06 |
| 1124408174 | Adam Wied | Physical Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2015-06-04 |
| 1598150864 | St. Mary's Hospital Medical Center of Green Bay Inc.-hospital Sisters | Family Medicine | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2015-04-02 |
| 1609287457 | Samantha Elizabeth Heezen | Physical Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2014-05-14 |
| 1457773483 | Natalie Binder | Physical Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2014-01-10 |
| 1164853826 | Ashley Ziegler | Physical Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2013-12-06 |
| 1811328875 | Brenda Hella | Occupational Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2013-12-02 |
| 1467889006 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Durable Medical Equipment & Medical Supplies | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2013-09-27 |
| 1154684942 | Ashley Verbeten | Physical Therapist | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2012-06-18 |
| 1093955411 | Connie Bloedel | Dietitian, Registered | 1727 Shawano Ave, Green Bay, WI 54303-3268 | 2009-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396824074 | Cardiology Associates of Green Bay, Ltd | Internal Medicine | 744 S. Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-11-03 |
| 1407828676 | Ramon Ray Gregorio Rayel | Internal Medicine | 2845 Greenbrier Rd Ste 310, Green Bay, WI 54311-6519 | 2006-02-02 |
| 1639157936 | Peter Fergus | Internal Medicine | 1727 Shawano Ave, Ste 201, Green Bay, WI 54303-3273 | 2006-01-06 |
| 1245659051 | Laura S Beacher | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2014-04-09 |
| 1467771535 | Bellin Memorial Hospital Inc | Internal Medicine | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2010-05-27 |
| 1174841985 | Armaan C Shaikh | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54311 | 2010-05-04 |
| 1750534533 | Bellin Memorial Hospital Inc | Internal Medicine | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2008-10-24 |
| 1609027168 | Kendra Marsh-kates | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2008-10-02 |
| 1659412401 | Green Bay Cardiothoracic & Vascular LLC | Internal Medicine | 720 S Van Buren St, Suite 303, Green Bay, WI 54301-3538 | 2007-02-12 |
| 1336238161 | Mohammad R. Jazayeri | Internal Medicine | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-10-12 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.