NPIMap

Organization Active NPI

Ford Center for Pain Management

  • Interventional Pain Medicine Physician
  • Cleveland, TN
National Provider Identifier
1619009065
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
1196 Issued in TN
Legal business name
FORD CENTER FOR PAIN MANAGEMENT
Practice address
2020 Keith St NW
Ste C
Cleveland, TN 37311-1351
Phone
(423) 614-0535
Fax
(423) 614-0545
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Authorized official

Name
Dennis C. Ford, MDNPI 1063470045
Title
Owner Supervising M.D.
Phone
(423) 614-0535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 10501 TN
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 12143 TN
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 1196 TN Primary

Addresses

Primary practice location

2020 Keith St NW
Ste C
Cleveland, TN 37311-1351

Mailing address

2020 Keith St NW
Ste C
Cleveland, TN 37311-1351
Phone (423) 614-0535

Other identifiers 4

IdentifierTypeStateIssuer
3377550OtherTNMEDICARE GROUP
4041359OtherTNMD BLUE CROSS BLUE SHIELD
44D1041380OtherTNDEPT HEALTH CLIA
3377550MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428001518 TN Part B Supplier - Clinic/Group Practice 3375530512 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Cleveland, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1619009065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 KEITH ST NW",
            "address_2": "STE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111351",
            "telephone_number": "423-614-0535",
            "fax_number": "423-614-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 KEITH ST NW",
            "address_2": "STE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111351",
            "telephone_number": "423-614-0535",
            "fax_number": "423-614-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORD CENTER FOR PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER SUPERVISING M.D.",
        "authorized_official_telephone_number": "423-614-0535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "10501",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "12143",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TN",
            "license": "1196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3377550",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BLUE CROSS BLUE SHIELD",
            "identifier": "4041359",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT HEALTH CLIA",
            "identifier": "44D1041380",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3377550",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.