Active NPI
Gregory Raymon Ford Jr.
- Nurse Practitioner
- Douglasville, GA
National Provider Identifier
1003428574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN-NP334093
- Practice address
- 5188 Carter Way
Douglasville, GA 30135-7170 - Phone
- (678) 230-4555
- NPI assigned
- Aug 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9480288 | FL | |
| Nurse Practitioner | 363L00000X | APRN-NP334093 | GA | Primary |
Addresses
Primary practice location
5188 Carter Way
Douglasville, GA 30135-7170
Mailing address
5188 Carter Way
Douglasville, GA 30135-7170
Phone (904) 445-7228
Other practice location 1
2702 Schaul St
Columbus, GA 31906-2123
Phone (706) 641-2441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9480288 | FL | MD | Registered Nurse |
| APRN-NP334093 | GA | MD | Nurse Practitioner |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CDHCDA/Endpoint/CDHCDA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1003428574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5188 CARTER WAY",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301357170",
"telephone_number": "904-445-7228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5188 CARTER WAY",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301357170",
"telephone_number": "678-230-4555"
}
],
"practiceLocations": [
{
"address_1": "2702 Schaul St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "GA",
"postal_code": "319062123",
"country_code": "US",
"telephone_number": "706-641-2441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORD",
"first_name": "GREGORY",
"middle_name": "RAYMON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-17",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9480288",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "APRN-NP334093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.