NPIMap

Individual provider Active NPI

Grace P Ford, FNP-BC

  • Nurse Practitioner
  • Poplarville, MS
National Provider Identifier
1376815134
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
875721 Issued in MS
Practice address
302 Highway 11 S
Poplarville, MS 39470-2625
Phone
(601) 403-8283
Fax
(601) 403-8283
NPI assigned
Feb 8, 2012
Last updated
Nov 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 875721 MS Primary

Addresses

Primary practice location

302 Highway 11 S
Poplarville, MS 39470-2625

Mailing address

305 W Moody St
Poplarville, MS 39470-7338
Phone (601) 795-4543

Other names 1

  • Grace P O'Hara Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000665 MS Practitioner - Nurse Practitioner 5496915753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Suite 410
Gulfport, MS 39501-2459
Phone (228) 867-5202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
875721MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Dec 15, 2017 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Pearl River County Hospital CurrentSince Dec 15, 2017 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Nov 16, 2020 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 410
Gulfport, MS 39501
Phone (228) 575-1775

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4855

302 Highway 11 S
Poplarville, MS 39470
Phone (601) 403-8284

305 W Moody St
Poplarville, MS 39470
Phone (601) 795-4345

305 W Moody St
#H
Poplarville, MS 39470
Phone (601) 795-4345

Interoperability endpoints

  • Direct secure messaging: grace.ford@direct.mhg.com

Organizations & group practices 6

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1376815134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W MOODY ST",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394707338",
            "telephone_number": "601-795-4543",
            "fax_number": "601-795-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 HIGHWAY 11 S",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394702625",
            "telephone_number": "601-403-8283",
            "fax_number": "601-403-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "GRACE",
        "middle_name": "P",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "875721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "O'HARA",
            "middle_name": "P",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Poplarville, MS

Sources for this page

Verify at the official NPI Registry.