Kimberly Jo Fordham, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A78858 Issued in CA

Practice address

21337 Bush Street
Middletown, CA 95461-1519

Phone

(707) 987-3311

Fax

(707) 987-2455

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Jo Melde Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031

  CA

  Medicare reassignment NPD
• Adventist Health California Medical Group, Inc.

  • Internal Medicine Physician
  • Saint Helena, CA
  • NPI 1437474269
  NPD (past)
• Adventist Health Clearlake Hospital Inc.

  • Rural Health Clinic/Center
  • Middletown, CA
  • NPI 1972593788
  NPD (past)
• Adventist Health Clearlake Hospital, Inc

  • Rural Health Clinic/Center
  • Lakeport, CA
  • NPI 1871063040
  NPD (past)

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

94

Promoting interoperability

92

Improvement activities

40

Cost

65.12

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1376568808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1519",
            "address_2": "21337 BUSH STREET",
            "city": "MIDDLETOWN",
            "state": "CA",
            "postal_code": "954611519",
            "telephone_number": "707-987-3311",
            "fax_number": "707-987-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21337 BUSH STREET",
            "city": "MIDDLETOWN",
            "state": "CA",
            "postal_code": "954611519",
            "telephone_number": "707-987-3311",
            "fax_number": "707-987-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A78858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MELDE",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adventist Health Clearlake Hospital Inc.
• Joseph Leigh Bower, D.C.
• Colina Cabarloc-Arreola
• Nicole Francis
• Ian Van Zyl BDS,DDS,Ms & Ewa Konopka,DDS,Apc
• Lynn Jordan, RN, MSN, FNP
• Kalonturos Chiropractic, Inc.
• Ewa Konopka, DDS

• All providers in Middletown, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.