Charles Davis Ford, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

38666 Issued in TN

Practice address

631 RB Wilson Dr
Huntingdon, TN 38344-1727

Phone

(731) 986-4461

Fax

(865) 291-3228

NPI assigned

Jun 6, 2006

Last updated

Nov 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Utah School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Tennessee Regional Health System Lawrence Hospital, Lawrenceburg, TN, CCN 440175
• Southern Tennessee Regional Health System Winchest Hospital, Winchester, TN, CCN 440058
• Southern Tennessee Regional Health System Pulaski Hospital, Pulaski, TN, CCN 440020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment Care Compare group NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine

  Medicare reassignment NPD
• Emergency Staffing Solutions Inc

  • Emergency Medicine Physician
  • Many, LA
  • NPI 1477590974

  TN

  Medicare reassignment NPD
• Hospital Medicine Services of Tennessee PC

  • Hospitalist Physician
  • Lawrenceburg, IN
  • NPI 1528433802

  TN

  Medicare reassignment NPD
• Beechlake Emergency Physicians

  • Emergency Medicine Physician
  • Lexington, TN
  • NPI 1124077748
  NPD (past)
• Hub City Emergency Physicians LLC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1972552651
  NPD (past)
• Oregon Trail Emergency Physicians LLC

  • Emergency Medicine Physician
  • Casper, WY
  • NPI 1518125384
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crockett Hospital LLC

  dba Southern Tennessee Regional Health System Lawrenceburg

  • Rural Acute Care Hospital
  • Lawrenceburg, TN
  • NPI 1114003175
  Care Compare affiliation
• Hillside Hospital LLC

  dba Southern Tennessee Regional Health System Pulaski

  • Rural Acute Care Hospital
  • Pulaski, TN
  • NPI 1841388519
  Care Compare affiliation
• Southern Tennessee Medical Center LLC

  dba Highpoint Health - Winchester with Ascension Saint Thomas

  • General Acute Care Hospital
  • Winchester, TN
  • NPI 1467408781
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1063451672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636019",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 RB WILSON DR",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441727",
            "telephone_number": "731-986-4461",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "CHARLES",
        "middle_name": "DAVIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "38666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emily Smothers Ezell, D.O.
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC
• Amanda Ruth Fuller, FNP-BC
• Brenda Fuller
• Heather Anne Garrett, FNP
• GTW, LLC (Tristar Family Care)
• David Michael Hall, M.D.

• Emergency Medicine Physician in Huntingdon, TN
• Providers in Huntingdon, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.