MEDICARE: ATLANTIC NEPHROLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	ME94793	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	40336	OTHER	FL	MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AD824Z	OTHER	FL	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376704155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC NEPHROLOGY INC

Provider Business Mailing Address
First Line	:	210 OLD KINGS RD S STE 900
Second Line	:
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-4380
Country	:	US
Telephone Number	:	386-338-3550
Fax Number	:	386-338-3551

Provider Business Practice Location Address
First Line	:	210 OLD KINGS RD S STE 900
Second Line	:
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-4380
Country	:	US
Telephone Number	:	383-338-3550
Fax Number	:	386-338-3551

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. WILLIAM BONLORE FERGUSON
Credential	:	MD, PHD
Telephone Number	:	386-871-3767

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	09/15/2025

Similar Medicare Providers

1073692893 — THOMAS J. HUBBARD, M.D., INC
Practice Location Address:

329 PHILLIP AVE
VIRGINIA BEACH, VA
23454-4380

Practice Phone: 757-687-1900
Practice Fax: 757-687-1895

1396928818 — EMMANUEL MEDICAL SUPPLY
Practice Location Address:

1330 E SOUTH ST STE 5
LONG BEACH, CA
90805-4380

Practice Phone: 562-422-3999
Practice Fax: 562-422-3988

1073798104 — DR. THOMAS J HUBBARD MD
Practice Location Address:

329 PHILLIP AVE
VIRGINIA BEACH, VA
23454-4380

Practice Phone: 757-687-1900
Practice Fax: 757-687-1895

1518282862 — PROFESSIONAL FAMILY EYECARE, INC
Practice Location Address:

137 S STATE ROAD 7 , SUITE 303
ROYAL PALM BEACH, FL
33414-4380

Practice Phone: 561-798-7432
Practice Fax: 561-791-4430

1679900526 — SAGE DENTAL OF ROYAL PALM BEACH, PLLC
Practice Location Address:

137 S STATE ROAD 7 , SUITE 301
ROYAL PALM BEACH, FL
33414-4380

Practice Phone: 561-202-6880
Practice Fax: 561-431-8169

1124422027 — CITY OF SATELLITE BEACH
Practice Location Address:

1390 S PATRICK DR
SATELLITE BEACH, FL
32937-4380

Practice Phone: 321-773-4405
Practice Fax:

Directions to “ATLANTIC NEPHROLOGY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.