Charles Davis Ford, MD

Key facts

NPI

1063451672

Entity type

Individual (NPI type 1)

Primary specialty

Emergency Medicine Physician 207P00000X

License

38666 (TN)

Practice address

631 RB Wilson Dr
Huntingdon, TN 38344-1727

Phone

(731) 986-4461

Fax

(865) 291-3228

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 8

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

• Southeastern Emergency Physicians LLC Emergency Medicine Physician · Maysville, KY · NPI 1356379382
  Medicare reassignment Care Compare group NPD EMERGENCY MEDICINE · TN
• Emergency Coverage, LLC Family Medicine Physician · Newport, TN · NPI 1427005008
  Medicare reassignment NPD EMERGENCY MEDICINE · TN
• Emergency Staffing Solutions Inc Emergency Medicine Physician · Many, LA · NPI 1477590974
  Medicare reassignment NPD EMERGENCY MEDICINE · TN
• Hospital Medicine Services of Tennessee PC Hospitalist Physician · Lawrenceburg, IN · NPI 1528433802
  Medicare reassignment NPD TN
• Beechlake Emergency Physicians Emergency Medicine Physician · Lexington, TN · NPI 1124077748
  NPD (past) EMERGENCY MEDICINE
• Hub City Emergency Physicians LLC Emergency Medicine Physician · Jackson, TN · NPI 1972552651
  NPD (past) EMERGENCY MEDICINE
• Lander Valley Physician Practices, LLC Psychiatry Physician · Lander, WY · NPI 1215971510
  NPD (past)
• Oregon Trail Emergency Physicians LLC Emergency Medicine Physician · Casper, WY · NPI 1518125384
  NPD (past) EMERGENCY MEDICINE

Hospital & facility affiliations 3

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

• Crockett Hospital LLC Rural Acute Care Hospital · Lawrenceburg, TN · NPI 1114003175
  Care Compare affiliation Hospital
• Hillside Hospital LLC Rural Acute Care Hospital · Pulaski, TN · NPI 1841388519
  Care Compare affiliation Hospital
• Southern Tennessee Medical Center LLC General Acute Care Hospital · Winchester, TN · NPI 1467408781
  Care Compare affiliation Hospital

Medicare Care Compare profile

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 LLC (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 participation

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 7, 2007.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4110535",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00255517",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3898586",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Huntingdon, TN · Emergency Medicine Physician in Tennessee