Individual provider Active NPI

David E Ford, M.ED., ATC, LAT

  • Athletic Trainer
  • Columbia, MO
National Provider Identifier
1396156097
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2009024722 Issued in MO
Practice address
3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517
Phone
(573) 449-8771
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2009024722 MO Primary

Addresses

Primary practice location

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517

Mailing address

2605 Shamrock Dr
Columbia, MO 65202-5549
Phone (660) 676-1543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2009024722MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1396156097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 SHAMROCK DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652025549",
            "telephone_number": "660-676-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "M.ED., ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2009024722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.