Active NPI
Sydne Danielle Ford, M.D.
- Family Medicine Physician
- Acworth, GA
National Provider Identifier
1417334285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 80730
- Practice address
- 4791 S Main St
Acworth, GA 30101-5324 - Phone
- (404) 251-1600
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 54857 | AZ | |
| Family Medicine Physician | 207Q00000X | R74970 | AZ | |
| Family Medicine Physician | 207Q00000X | 80730 | GA | Primary |
Addresses
Primary practice location
4791 S Main St
Acworth, GA 30101-5324
Mailing address
4791 S Main St
Acworth, GA 30101-5324
Phone (404) 251-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 6, 2023 through Mar 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54857 | AZ | MD | Family Medicine Physician |
| R74970 | AZ | MD | Family Medicine Physician |
| 80730 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1417334285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4791 S MAIN ST",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301015324",
"telephone_number": "404-251-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4791 S MAIN ST",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301015324",
"telephone_number": "404-251-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "SYDNE",
"middle_name": "DANIELLE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "54857",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "R74970",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "80730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.