Individual provider Active NPI

William Chester Ford Jr., NP-C

  • Family Nurse Practitioner
  • Bethel, AK
National Provider Identifier
1124006200
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
121442 Issued in AK
Practice address
1124006200
829 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Phone
(907) 543-6430
NPI assigned
Jan 9, 2006
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 121442 AK Primary
Family Nurse Practitioner 363LF0000X RN144697 GA

Addresses

Primary practice location

1124006200
829 Chief Eddie Hoffman Hwy
Bethel, AK 99559

Mailing address

5555 E Pamela Dr
Wasilla, AK 99654-0552
Phone (706) 498-2361

Other identifiers 1

IdentifierTypeStateIssuer
1669291MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000714 GA Practitioner - Nurse Practitioner 4587633409 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
121442AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Heart Center, PC CurrentSince Apr 14, 2015 Accepting new patients

Locations

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

11973 Augusta Rd
Lavonia, GA 30553
Phone (706) 356-8181

11973 Augusta Rd
#R5D
Lavonia, GA 30553

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1124006200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E PAMELA DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996540552",
            "telephone_number": "706-498-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124006200",
            "address_2": "829 CHIEF EDDIE HOFFMAN HWY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "WILLIAM",
        "middle_name": "CHESTER",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "121442",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN144697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669291",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

Verify at the official NPI Registry.