Individual provider Active NPI

John Charles Ford, DDS

  • Dentist
  • Germantown, TN
National Provider Identifier
1316029440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS3725 Issued in TN
Practice address
7500 Enterprise Ave
Germantown, TN 38138-3849
Phone
(901) 754-3562
Fax
(901) 757-1913
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS3725 TN Primary

Addresses

Primary practice location

7500 Enterprise Ave
Germantown, TN 38138-3849

Mailing address

7500 Enterprise Ave
Germantown, TN 38138-3849
Phone (901) 754-3562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161014001332 TN Order and Referring Only - DentistPractitioner - Dentist 1951699578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS3725TNMDDentist

Interoperability endpoints

  • Direct secure messaging: john.ford.1@28179.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316029440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 ENTERPRISE AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383849",
            "telephone_number": "901-754-3562",
            "fax_number": "901-757-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 ENTERPRISE AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383849",
            "telephone_number": "901-754-3562",
            "fax_number": "901-757-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS3725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.