TRACY FERGUSON (M.D.) – Pediatrics Physician, NPI 1922063734

TRACY FERGUSON (M.D.) is a healthcare provider. based in Clarkston, Georgia. specializing in Pediatrics Physician. They hold the professional credentials M.D.. They hold a License No. 054023 (GA). The NPI Number for TRACY FERGUSON (M.D.) is 1922063734

Main info

Female
Name
TRACY FERGUSON (M.D.)
NPI
1922063734
Phone
(404) 296-7133
Address
4112 E PONCE DE LEON AVE
Enumeration Date
18 April 2006
Last Update Date
13 January 2022

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for TRACY FERGUSON (M.D.)

  • 4112, East Ponce de Leon Avenue, Clarkston, DeKalb County, Georgia, 30021, United States

    CLARKSTON, GA 300218106

    Phone: (404) 296-7133

    Fax: (404) 296-7211

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-08-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200813003609IPediatric MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30021)

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Reviews

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Frequently asked questions

Can I verify TRACY FERGUSON (M.D.) with an NPI only?
You can start verification with NPI 1922063734 for TRACY FERGUSON (M.D.), then check state licensing separately.
Can I rely on TRACY FERGUSON (M.D.) being an active provider?
As of the registry snapshot, TRACY FERGUSON (M.D.) is marked active.
What is TRACY FERGUSON (M.D.)'s specialty?
The listing groups TRACY FERGUSON (M.D.) with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Does TRACY FERGUSON (M.D.) list a practice location?
Patients near Clarkston, Georgia may find TRACY FERGUSON (M.D.) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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