Active NPI
Jeremiah Daniel Ford, PH.D.
- Clinical Psychologist
- Beaufort, SC
National Provider Identifier
1245674910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05083
- Practice address
- 1 Pinckney Blvd
Beaufort, SC 29902-6122 - Phone
- (843) 228-2201
- NPI assigned
- Apr 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 05083 | MD | Primary |
Addresses
Primary practice location
1 Pinckney Blvd
Beaufort, SC 29902-6122
Mailing address
1 Pinckney Blvd
Beaufort, SC 29902-6122
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05083 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1245674910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PINCKNEY BLVD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299026122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PINCKNEY BLVD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299026122",
"telephone_number": "843-228-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "JEREMIAH",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-24",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaufort, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.