Individual provider Active NPI

Erika Ford, RDN

  • Registered Dietitian
  • Portage, MI
National Provider Identifier
1699108589
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86013124 Issued in MI
Practice address
7901 S 12TH St Ste 200
Portage, MI 49024-3831
Phone
(269) 341-8900
Fax
(269) 341-8931
NPI assigned
Aug 14, 2013
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 931 WV
Registered Dietitian 133V00000X 86013124 MI Primary

Addresses

Primary practice location

7901 S 12TH St Ste 200
Portage, MI 49024-3831

Mailing address

7901 S 12TH St Ste 200
Portage, MI 49024-3831
Phone (269) 341-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019002973 MI Practitioner - Registered Dietitian Or Nutrition Professional 5193015899 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86013124MIMDRegistered Dietitian
931WVMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Nov 1, 2017 Accepting new patients
Untamed Nutrition Therapy, LLC Dietitian, Registered Past Accepting new patients

Locations

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

7901 S 12th St
Ste 200
Portage, MI 49024
Phone (269) 341-8585

Organizations & group practices 2

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1699108589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 S 12TH ST STE 200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243831",
            "telephone_number": "269-341-8900",
            "fax_number": "269-341-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 S 12TH ST STE 200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243831",
            "telephone_number": "269-341-8900",
            "fax_number": "269-341-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "ERIKA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WV",
            "license": "931",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86013124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.