NPIMap

Individual provider Active NPI

Mary Ford

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1740808906
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2 Medical Park Rd Ste 506
Columbia, SC 29203-6876
Phone
(803) 434-3560
Fax
(803) 545-5303
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2 Medical Park Rd Ste 506
Columbia, SC 29203-6876

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

110 S Main St
Boiling Springs, NC 28017-9797
Phone (704) 406-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211012000523 SC Practitioner - Physician Assistant 8628476256
I20251217002878 NC Practitioner - Physician Assistant 8628476256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

4525 Cameron Valley Pkwy
Suite 2100
Charlotte, NC 28211-4375
Phone (704) 355-5100

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4050SCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 27, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 8, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 27, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 8, 2025 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Ste 2100
Charlotte, NC 28211
Phone (704) 302-8350

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

9 Richland Medical Park Dr
Ste 430
Columbia, SC 29203
Phone (803) 434-3560

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: mford818265@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1740808906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD STE 506",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036876",
            "telephone_number": "803-434-3560",
            "fax_number": "803-545-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S Main St",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "NC",
            "postal_code": "280179797",
            "country_code": "US",
            "telephone_number": "704-406-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.