Ford Home

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FORD HOME

Practice address

510 College St
Jacksonville, NC 28540-4706

Phone

(910) 937-6000

Fax

(910) 347-4001

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Oliver Wendell Ford, LPN

Title

President

Phone

(910) 381-0125

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Ford Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ford Home

  • Community/Behavioral Health Agency
  • Jacksonville, NC
  • NPI 1104005735
  NPD tax ID
• Ford Home

  • Community/Behavioral Health Agency
  • Jacksonville, NC
  • NPI 1932223617
  NPD tax ID

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1811038722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5182",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285401182",
            "telephone_number": "910-937-6000",
            "fax_number": "910-347-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404706",
            "telephone_number": "910-937-6000",
            "fax_number": "910-347-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORD HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "WENDELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-381-0125",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301299",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301299B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Joseph Flynt, PHARM.D.
• Sue Fockler, NURSE PRAC
• Karen Marie Foley
• Emily Anne Fontinha, PA
• Ford Home
• Ford Home
• Aisha Ford, RD, LDN
• Stacey Lynn Ford, LPC
• Matthew Snider Foster, BSRPH
• Fountain Therapeutic and Supportive Services LLC

• Community/Behavioral Health Agency in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.