Sara Lee Fordham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209019936 Issued in IL

Practice address

403 E 1St St
Dixon, IL 61021-3116

Phone

(815) 288-5531

NPI assigned

Aug 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rna of Rockford, PLLCGroup PAC ID 3870662398, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CGH Medical Center Hospital, Sterling, IL, CCN 140043
• Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
• Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310

Merit-based Incentive Payment System (MIPS)

Final score

94.99 of 100Reported as group

Quality

83.04

Promoting interoperability

100

Improvement activities

40

Cost

77.67

Merit-based Incentive Payment System (MIPS)

Final score

82.78 of 100Reported as group

Quality

60.49

Promoting interoperability

100

Improvement activities

40

Cost

77.11

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sara.fordham.1@19234.direct.athenahealth.com
• Direct secure messaging: sfordham21022@cghmc.direct-ci.com

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.

• Rna of Rockford, PLLC

  • Nephrology Physician
  • Rockford, IL
  • NPI 1336326388
  Medicare reassignment Care Compare group NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Care Compare affiliation
• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  Care Compare affiliation

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1871141465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-288-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-288-5531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S Hennepin Ave",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "610213013",
            "country_code": "US",
            "telephone_number": "815-288-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "SARA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felkers Snyder Pharmacy
• Trudie Ann Flaningam
• Larissa Flynn, RBT
• Cara Lee Fontana, DPM
• Kayla Fordham
• Forman Clinic of Chiropractic Rehabilitation
• Eric Dean Forman, D.C.
• Gabriel Lynn Fossett, LSW
• Skyler P Fountain
• Josey Fox, MHP

• Family Nurse Practitioner in Dixon, IL
• Providers in Dixon, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.

Verify at the official NPI Registry.