Edrick Jordan Ferguson, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Canton, Illinois. His current practice location is
210 W Walnut St, Canton, Illinois. You can reach out to his office (for appointments etc.) via phone at
(309) 647-5240.
Edrick Jordan Ferguson is licensed to practice in Illinois (license number 036170509) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1659365872.
Physician's Profile
| Full Name | Edrick Jordan Ferguson |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 210 W Walnut St, Canton, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Edrick Jordan Ferguson attended and graduated from in
NPI Data:
- NPI Number: 1659365872
- Provider Enumeration Date: 09/02/2005
- Last Update Date: 12/23/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Edrick Jordan Ferguson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659365872 | NPI | - | NPPES |
| 1508037 | Medicaid | TN | |
| 000000270956 | Other | OH | ANTHEM |
| 4191954 | Other | TN | BLUE CROSS BLUE SHIELD |
| P00468253 | Other | | RAILROAD MEDICARE |
| 30885811 | Medicaid | TN | |
| 2383924 | Medicaid | OH | |
| 4166295 | Other | TN | BCBS PROVIDER NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 35079693 (Ohio) | Secondary |
| 208D00000X | General Practice | 26307 (Tennessee) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 036170509 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edrick Jordan Ferguson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Edrick Jordan Ferguson, MD
611 W Park St,
Urbana, IL 61801-2500
Ph: () - | Edrick Jordan Ferguson, MD
210 W Walnut St,
Canton, IL 61520-2444
Ph: (309) 647-5240 |
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