Individual provider Active NPI

Samuel Edmond Ford, MD

  • Orthopaedic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1316357940
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2020-00102 Issued in NC
Practice address
2001 Vail Ave Ste 200
Charlotte, NC 28207-1219
Phone
(704) 323-3668
Fax
(704) 323-3948
NPI assigned
May 5, 2014
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2020-00102 NC Primary

Addresses

Primary practice location

2001 Vail Ave Ste 200
Charlotte, NC 28207-1219

Mailing address

4601 Park Rd
Ste 250
Charlotte, NC 28209-2290
Phone (704) 323-2237

Other identifiers 2

IdentifierTypeStateIssuer
NC4198MedicaidSC
1316357940MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200728000873 NC Practitioner - Orthopedic Surgery 2860723871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1219
Phone (704) 323-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue19
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Orthocarolina Orthopaedic Surgery Current Accepting new patients
Orthocarolina Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Medical Center Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Carolinas Medical Center CurrentSince Aug 1, 2020 Accepting new patients
Orthocarolina Orthopaedic Surgery PastSince Jun 1, 2020 Accepting new patients

Locations

540 Mount Holly Medical Pkwy
Belmont, NC 28012
Phone (704) 323-3337

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

2001 Vail Ave
Ste 200
Charlotte, NC 28207
Phone (704) 323-2564

2001 Vail Ave
Ste 200B
Charlotte, NC 28207
Phone (704) 323-3668

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

5935 Carnegie Blvd
Ste 200
Charlotte, NC 28209

870 Summit Crossing Pl
Gastonia, NC 28054
Phone (704) 671-1860

3900 Junius St
Ste 500
Dallas, TX 75246
Phone (214) 823-7090

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: sford537443@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1316357940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071219",
            "telephone_number": "704-323-3668",
            "fax_number": "704-323-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SAMUEL",
        "middle_name": "EDMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2020-00102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC4198",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316357940",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.