Charles D Ford Jr., MD
Individual provider Active NPI Emergency Medicine Physician · Ripley, TN
NPI 1831400449 · NPPES record last updated Aug 29, 2013
Key facts
- NPI
- 1831400449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 49829 (TN)
- Practice address
- 326 Asbury Ave
Ripley, TN 38063-5577 - Phone
- (731) 221-2200
- Fax
- (865) 305-8894
- NPI assigned
- Jun 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130530000262 | TN | Practitioner - Emergency Medicine | 3779721907 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Staffing Solutions Inc | Emergency Medicine | Current |
Accepting new patients |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Coverage, LLC | Emergency Medicine | Current |
Accepting new patients |
| Concord Medical Group PLLC | Emergency Medicine | Current |
Accepting new patients |
| Concord Medical Group of Texas PLLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Coverage Services, PC | Past | Accepting new patients |
Locations
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
188 Hospital Ln
Jellico, TN 37762
Phone (423) 784-1272
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586
326 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 49829 | TN | Yes |
Addresses
Primary practice location
326 Asbury Ave
Ripley, TN 38063-5577
Mailing address
326 Asbury Ave
Ripley, TN 38063-5577
Phone (731) 221-2200
Other providers in Ripley, TN
- Dr. Tracy Morris
- B Wayne Dudney
- Marquita Durham
- Elite Dental Care Ripley
- Eye Care Group, PLLC
- Freds Stores of Tennessee Inc
- Freds Stores of Tennessee Inc
- Gail D Gause
- Cynthia H Glenn
- Pamela H Glenn
All providers in Ripley, TN · Emergency Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.