NPIMap

Organization Active NPI

Appalachia Medical Clinic, PC

  • Family Medicine Physician
  • Appalachia, VA
National Provider Identifier
1760613996
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101020991 Issued in VA
Legal business name
APPALACHIA MEDICAL CLINIC, PC
Practice address
127 Callahan Ave
Appalachia, VA 24216-1203
Phone
(276) 565-2425
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Authorized official

Name
Dr. Michael B Ford, MD
Title
Owner
Phone
(276) 565-2425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0101020991 VA Primary

Addresses

Primary practice location

127 Callahan Ave
Appalachia, VA 24216-1203

Mailing address

127 Callahan Ave
Appalachia, VA 24216-1203
Phone (276) 565-2425

Other identifiers 2

IdentifierTypeStateIssuer
005639531MedicaidVA
64662299MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1760613996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CALLAHAN AVE",
            "city": "APPALACHIA",
            "state": "VA",
            "postal_code": "242161203",
            "telephone_number": "276-565-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CALLAHAN AVE",
            "city": "APPALACHIA",
            "state": "VA",
            "postal_code": "242161203",
            "telephone_number": "276-565-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIA MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-565-2425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101020991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005639531",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64662299",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appalachia, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.