Individual provider Active NPI

Kenneth Alan Ford, FNP

  • Nurse Practitioner
  • Carolina Shores, NC
National Provider Identifier
1881890846
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0050-03120 Issued in NC
Practice address
75 Emerson Bay Rd
Carolina Shores, NC 28467-2498
Phone
(910) 579-8363
Fax
(910) 579-8306
NPI assigned
Jun 26, 2007
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0050-03120 NC Primary

Addresses

Primary practice location

75 Emerson Bay Rd
Carolina Shores, NC 28467-2498

Mailing address

2850 Tate Blvd SE
Hickory, NC 28602-1450
Phone (828) 326-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, VA, DC, GA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20230223000312 NC Practitioner - Nurse Practitioner 9032209432 Reassigns benefits to 5 organizations
I20260105003210 SC Practitioner - Nurse Practitioner 9032209432 Reassigns benefits to 1 organization
I20260107001672 VA Practitioner - Nurse Practitioner 9032209432 Reassigns benefits to 1 organization
I20260110000304 DC Practitioner - Nurse Practitioner 9032209432 Reassigns benefits to 1 organization
I20260113003722 GA Practitioner - Nurse Practitioner 9032209432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5410 Maryland Way
Suite 400
Brentwood, TN 37027-8087

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0050-03120NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri County Community Health Council Inc CurrentSince Oct 26, 2022 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Oct 30, 2025 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Dec 26, 2025 Accepting new patients
Cape Fear Clinic, Inc. CurrentSince Mar 23, 2024 Accepting new patients
Monogram Health Professional Services of North Carolina PC Nurse Practitioner CurrentSince Jul 18, 2025 Accepting new patients
Tri County Community Health Council Inc Current Accepting new patients
Tri County Community Health Council Inc CurrentSince Oct 26, 2022 Accepting new patients
Carolina Quickcare Family Practice, PLLC CurrentSince Feb 7, 2023 Accepting new patients

Locations

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 704-4342

2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054

3331 Easy St
Dunn, NC 28334

341A Whiteville Rd NW
Shallotte, NC 28470
Phone (910) 754-8731

1605 Doctors Cir
Wilmington, NC 28401
Phone (910) 343-8736

615 Saint George Square Ct
Ste 300
Winston Salem, NC 27103
Phone (336) 793-8125

128 Millport Cir
Ste 200
Greenville, SC 29607
Phone (240) 877-9865

5680 King Centre Dr
Ste 600
Kingstowne, VA 22315
Phone (703) 201-8558

919 E Main St
Ste 1000
Richmond, VA 23219
Phone (804) 729-6904

Interoperability endpoints

  • Direct secure messaging: kenneth.ford.1@22854.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1881890846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 TATE BLVD SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021450",
            "telephone_number": "828-326-7000",
            "fax_number": "828-326-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 EMERSON BAY RD",
            "city": "CAROLINA SHORES",
            "state": "NC",
            "postal_code": "284672498",
            "telephone_number": "910-579-8363",
            "fax_number": "910-579-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "0050-03120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina Shores, NC

Sources for this page

Verify at the official NPI Registry.