Habersham Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

044718 Issued in GA

Legal business name

HABERSHAM FAMILY MEDICINE

Practice address

865 Austin Dr
Demorest, GA 30535-4513

Phone

(706) 754-8811

Fax

(706) 754-8822

NPI assigned

Dec 2, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald L Fordham, M.D.NPI 1477537470

Title

Owner

Phone

(706) 754-8811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald L Fordham, M.D.

  • Family Medicine Physician
  • Demorest, GA
  • NPI 1477537470
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326022328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305350308",
            "telephone_number": "706-754-8811",
            "fax_number": "706-754-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 AUSTIN DR",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354513",
            "telephone_number": "706-754-8811",
            "fax_number": "706-754-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABERSHAM FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORDHAM",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-754-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "044718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Thomas Griswold, LMSW
• Finda L Guyton, MD
• Habersham Anesthesia Associates
• Habersham County Health Department
• Habersham Drug LTC
• Habersham Internal Medicine
• Habersham Medical Center Foundation, Inc. (I-CARE Pharmacy)
• Habersham OB/GYN Associates
• Habersham Pro-Care Anesthesia
• James G Hamilton Jr., M.D.

• Family Medicine Physician in Demorest, GA
• Providers in Demorest, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.