Active NPI
Colby Tyler Ford, PHD
- Clinical Molecular Genetics Physician
- Charlotte, NC
National Provider Identifier
1255002408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Molecular Genetics Physician
- License
- 0000000000
- Practice address
- 2413 Commonwealth Ave
Charlotte, NC 28205-5131 - Phone
- (828) 773-8009
- NPI assigned
- Sep 27, 2021
- Last updated
- Sep 27, 2021
- 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 Molecular Genetics Physician | 207SG0203X | 0000000000 | NC | Primary |
Addresses
Primary practice location
2413 Commonwealth Ave
Charlotte, NC 28205-5131
Mailing address
2413 Commonwealth Ave
Charlotte, NC 28205-5131
Phone (828) 773-8009
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 |
|---|---|---|---|
| 0000000000 | NC | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1255002408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 COMMONWEALTH AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055131",
"telephone_number": "828-773-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2413 COMMONWEALTH AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055131",
"telephone_number": "828-773-8009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "COLBY",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-27",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "NC",
"license": "0000000000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.