Rodney Dean Ford Jr., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.001223 Issued in IL

Practice address

4550 Memorial Dr. Office Center One Ste G100
Belleville, IL 62226-5372

Phone

(618) 236-2246

Fax

(618) 236-2315

NPI assigned

Jun 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1316233224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR. OFFICE CENTER ONE STE G100",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-236-2246",
            "fax_number": "618-236-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR. OFFICE CENTER ONE STE G100",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-236-2246",
            "fax_number": "618-236-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "RODNEY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.001223",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2000164612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teri Lynn Fleming, D.C.
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• Forrest and Associates PLLC
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• Kathleen K Fournier, MD
• Milana Nichelle Foxworth
• Carter Leroy Frank, M.A., L.C.P.C.

• Athletic Trainer in Belleville, IL
• Providers in Belleville, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.