Individual provider Active NPI

Lance Eugene Ford, DC

  • Chiropractor
  • Carthage, MO
National Provider Identifier
1386636314
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005639 Issued in MO
Practice address
612 S Main St
Carthage, MO 64836-1649
Phone
(417) 358-3201
Fax
(417) 358-4677
NPI assigned
Aug 16, 2005
Last updated
Jul 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005639 MO Primary

Addresses

Primary practice location

612 S Main St
Carthage, MO 64836-1649

Mailing address

612 S Main St
Carthage, MO 64836-1649
Phone (417) 358-3201

Other identifiers 5

IdentifierTypeStateIssuer
15148OtherMOBCBS
168267OtherMOHEALTHLINK
4038239OtherPAHEALTHMARKET
8851OtherMOCOX HEALTH SYSTEMS
758573406MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000219 MO Practitioner - Chiropractic 5294850129 Practice locations: Carthage, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

612 S Main St
Carthage, MO 64836-1649
Phone (417) 358-3201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1386636314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S MAIN ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361649",
            "telephone_number": "417-358-3201",
            "fax_number": "417-358-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MAIN ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361649",
            "telephone_number": "417-358-3201",
            "fax_number": "417-358-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "LANCE",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15148",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "168267",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHMARKET",
            "identifier": "4038239",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COX HEALTH SYSTEMS",
            "identifier": "8851",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758573406",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.