Individual provider Active NPI

Joy P Ford, PA-C

  • Physician Assistant
  • Summersville, WV
National Provider Identifier
1194717603
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1020 Issued in WV
Practice address
5870 Webster Rd
Summersville, WV 26651-9105
Phone
(304) 872-3709
NPI assigned
Aug 19, 2005
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1020 WV Primary

Addresses

Primary practice location

5870 Webster Rd
Summersville, WV 26651-9105

Mailing address

5870 Webster Rd
Summersville, WV 26651-9105
Phone (304) 872-3709

Other identifiers 1

IdentifierTypeStateIssuer
3810005937MedicaidWV

Other names 1

  • Joy P Young Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20040517000635 WV Practitioner - Physician Assistant 1658361076 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1020WVMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Apr 1, 2017 Accepting new patients
New River Health Association, Inc. Past Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

207 W Maple Ave
Fayetteville, WV 25840
Phone (304) 574-0120

Organizations & group practices 5

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1194717603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 WEBSTER RD",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266519105",
            "telephone_number": "304-872-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5870 WEBSTER RD",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266519105",
            "telephone_number": "304-872-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JOY",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005937",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "YOUNG",
            "middle_name": "P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summersville, WV

Sources for this page

Verify at the official NPI Registry.