Individual provider Active NPI

Nicholas P Ford, P.A.

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1598813909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001589 Issued in IA
Practice address
979 Oakridge Dr
Des Moines, IA 50314-2102
Phone
(515) 248-1500
Fax
(515) 248-1510
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001589 IA Primary

Addresses

Primary practice location

979 Oakridge Dr
Des Moines, IA 50314-2102

Mailing address

2353 SE 14TH St
Des Moines, IA 50320-1109
Phone (515) 248-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729000284 IA Practitioner - Physician Assistant 7214108752 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

11144 Aurora Ave
Urbandale, IA 50322-7903
Phone (515) 278-6868

3540 E 46TH St
Concentra Urgent Care
Davenport, IA 52807-3403
Phone (563) 359-1170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001589IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Jul 15, 2019 Accepting new patients
American Current Care P.a. CurrentSince Jul 15, 2019 Accepting new patients
Knoxville Community Hospital Inc Physician Assistant CurrentSince Jan 4, 2016 Accepting new patients
Primary Health Care, Inc. Past Accepting new patients

Locations

3540 E 46th St
Davenport, IA 52807
Phone (563) 359-1170

1202 W Howard St
Knoxville, IA 50138
Phone (641) 828-7144

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598813909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2353 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201109",
            "telephone_number": "515-248-1400",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 OAKRIDGE DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142102",
            "telephone_number": "515-248-1500",
            "fax_number": "515-248-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "NICHOLAS",
        "middle_name": "P",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.