Active NPI
Nichole Birdsong Ford, MD
- Family Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- T9685
- Practice address
- 1000 E 5TH St Ste 400
Tyler, TX 75701-3362 - Phone
- (903) 596-3500
- Fax
- (903) 596-3132
- NPI assigned
- Mar 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | T9685 | TX | Primary |
Addresses
Primary practice location
1000 E 5TH St Ste 400
Tyler, TX 75701-3362
Mailing address
1000 E 5TH St Ste 400
Tyler, TX 75701-3362
Phone (903) 596-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Texas Tech University Health Science Center School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 E 5TH St
Suite 400
Tyler, TX 75701-3362
Phone (903) 596-3500
18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T9685 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| Starks Medical | Past | Accepting new patients |
Locations
18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292
1000 E 5th St
Ste 200
Tyler, TX 75701
Phone (903) 594-2666
1000 E 5th St
Ste 400
Tyler, TX 75701
Phone (903) 593-1749
Interoperability endpoints
- nford707042@ahs.direct-ci.com
- nichole.birdsong@hca5.eclinicaldirectplus.com
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Tyler, TX
- NPI 1609382662
-
- Rural Health Clinic/Center
- Chandler, TX
- NPI 1235706581
-
- Primary Care Nurse Practitioner
- Bullard, TX
- NPI 1306570593
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Christus Mother Frances Hospital Tyler
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- Rehabilitation Hospital
- Tyler, TX
- NPI 1174021695
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1407364847
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1417941295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1760943310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E 5TH ST STE 400",
"city": "TYLER",
"state": "TX",
"postal_code": "757013362",
"telephone_number": "903-596-3500",
"fax_number": "903-596-3132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E 5TH ST STE 400",
"city": "TYLER",
"state": "TX",
"postal_code": "757013362",
"telephone_number": "903-596-3500",
"fax_number": "903-596-3132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "NICHOLE",
"middle_name": "BIRDSONG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-27",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "T9685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.