Mallory Ferguson, is a medicare enrolled "Physical Therapist" provider in Mound City, Missouri. Her current practice location is
1401 Savannah St, Mound City, Missouri. You can reach out to her office (for appointments etc.) via phone at
(402) 301-9885.
Mallory Ferguson is licensed to practice in Missouri (license number 2005005090) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1346724176.
Healthcare Provider's Profile
| Full Name | Mallory Ferguson |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 1401 Savannah St, Mound City, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1346724176
- Provider Enumeration Date: 09/18/2018
- Last Update Date: 11/08/2019
Medicare PECOS Information:
- PECOS PAC ID: 0941633358
- Enrollment ID: I20191125002276
Medical Identifiers
Medical identifiers for Mallory Ferguson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1346724176 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT60868468 (Washington) | Secondary |
| 225100000X | Physical Therapist | 005225 (Iowa) | Secondary |
| 225100000X | Physical Therapist | 2005005090 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mallory Ferguson allows following entities to bill medicare on her behalf.
| Provider Name | Orthopedic & Sports Medicine Center Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1093780645
PECOS PAC ID: 5294700449
Enrollment ID: O20040903000403 |
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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. Mallory 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 |
|---|
Mallory Ferguson,
1401 Savannah St,
Mound City, MO 64470-1539
Ph: () - | Mallory Ferguson,
1401 Savannah St,
Mound City, MO 64470-1539
Ph: (402) 301-9885 |
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