Zackary Fordham, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD18034 Issued in ME

Practice address

4500 13TH St
Gulfport, MS 39502

Phone

(601) 672-3173

NPI assigned

Jan 4, 2007

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA, AL, WY, ME5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Emergency Medicine

Education

University of Mississippi School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
• Baptist Medical Center East Hospital, Montgomery, AL, CCN 010149
• Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108
• St Vincent's St Clair Hospital, Pell City, AL, CCN 010130
• Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zackary.fordham@xdr.hhchealthdirect.org
• Direct secure messaging: zfordham@direct.mhg.com

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.

• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459
  Medicare reassignment Care Compare group NPD (past)
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment Care Compare group
• Emergency Medicine Services of Maine, LLC

  • Emergency Medicine Physician
  • Ellsworth, ME
  • NPI 1578032058
  Medicare reassignment NPD
• Highland Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1154913861
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Medicare reassignment NPD
• Memorial Hospital of Converse County

  • General Practice Physician
  • Douglas, WY
  • NPI 1356496491
  Medicare reassignment NPD
• Professional Emergency Medicine Management -- Lake Charles LLC

  • Emergency Medicine Physician
  • Lake Charles, LA
  • NPI 1023430766
  Medicare reassignment NPD
• Emergency Services of Montgomery PC

  • Emergency Medicine Physician
  • Prattville, AL
  • NPI 1528310323
  Medicare reassignment NPD (past)
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  dba Memorial Emergency Physicians

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD
• Houston County Healthcare Authority

  dba SAMC- Profee Billing

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134

  Emergency Medicine

  NPD

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

• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1043542772

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1053643791

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Radiation Oncology Physician
  • Gulfport, MS
  • NPI 1063663490

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1063744704

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Urology Physician
  • Gulfport, MS
  • NPI 1093031494

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Memorial Stone County Medical Center

  • Family Medicine Physician
  • Wiggins, MS
  • NPI 1104477710

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Gastroenterology Physician
  • Gulfport, MS
  • NPI 1124311055

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Gulfport, MS
  • NPI 1184956815

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Physicians Clinic at MHG

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1205129137

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  Care Compare affiliation

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1265589089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39502",
            "telephone_number": "601-672-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39502",
            "telephone_number": "601-672-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "ZACKARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "28369",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "21091",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD18034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Bennett Fontenot
• Christy Fontes, DNP
• Katanya D Ford, D.C.
• Candice Forde, D.C.
• Justin Forde, D.C.
• Ariel Nicole Fore
• Nicholas Embey Fore
• Macey Darlene Forehand, D.P.T.
• Shelley S Foreman, LPC
• Brian H Foresman, D.O.

• Emergency Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.