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1295785855 NPI number — CAROLINE LIGON FERGUSON ATC, SCAT

NPI Number: 1295785855
Health Care Provider/Practitioner: CAROLINE LIGON FERGUSON ATC, SCAT

Information about “1295785855” NPI (CAROLINE LIGON FERGUSON ATC, SCAT) exists in 1295785855 in HTML format HTML  |  1295785855 in plain Text format TXT  |  1295785855 in PDF (Portable Document Format) PDF  |  1295785855 in an XML format XML  formats.

NPI Number : 1295785855 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295785855",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FERGUSON",
    "FirstName": "CAROLINE",
    "MiddleName": "LIGON",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "ATC, SCAT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SPEARMAN",
    "OtherFirstName": "CAROLINE",
    "OtherMiddleName": "LIGON",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "ATC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1970 SAM GILLESPIE BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUMTER",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29154",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "803-369-0442",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "716 FIGHTING FALCON ST BLDG 1606",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SHAWAFB",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29152",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "803-895-1867",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2006",
    "LastUpdateDate": "09/17/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "817",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT0000000925",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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