Active NPI
Candice Forde, D.C.
- Chiropractor
- Gulfport, MS
National Provider Identifier
1841613098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1217
- Practice address
- 1900 Pass Rd
Suite D
Gulfport, MS 39501-5100 - Phone
- (228) 864-6159
- Fax
- (228) 864-3186
- NPI assigned
- Jan 23, 2014
- Last updated
- Jan 23, 2014
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1217 | MS | Primary |
Addresses
Primary practice location
1900 Pass Rd
Suite D
Gulfport, MS 39501-5100
Mailing address
1900 Pass Rd
Suite D
Gulfport, MS 39501-5100
Phone (228) 864-6159
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2013
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
1204 E Pass Rd
Back in Motion Chiropractic
Gulfport, MS 39507-3403
Phone (228) 864-6159
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1217 | MS | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Life Center LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Gulfport, MS
- NPI 1033557921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1841613098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 PASS RD",
"address_2": "SUITE D",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395015100",
"telephone_number": "228-864-6159",
"fax_number": "228-864-3186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 PASS RD",
"address_2": "SUITE D",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395015100",
"telephone_number": "228-864-6159",
"fax_number": "228-864-3186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDE",
"first_name": "CANDICE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-23",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MS",
"license": "1217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.