Philip David Ford, PH.D., ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT527 Issued in ID

Practice address

1910 University Dr
Boise, ID 83725-1710

Phone

(208) 426-4278

NPI assigned

May 30, 2007

Last updated

Apr 15, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Boise State University

  • Clinical Medical Laboratory
  • Boise, ID
  • NPI 1770183089
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1871794446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 UNIVERSITY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837251710",
            "telephone_number": "208-426-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 UNIVERSITY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837251710",
            "telephone_number": "208-426-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "PHILIP",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.,  ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE BOARD OF MEDICINE",
            "identifier": "AT527",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Foothills Counseling & Wellness LLC
• Jennifer Forberg, RD, LD
• Andrew D. Forbes, MD
• Carrie Ford
• Madison Shae Ford, RD
• Richard N Foreman II, MD
• Forgiven P.a. (Coulter Family Chiropractic)
• Sarah Jane Forney
• Fors Functional Medicine (Fors Health Coaching)
• Antonio Marcos Forshey, DC

• Athletic Trainer in Boise, ID
• Providers in Boise, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.