Organization Active NPI

Ralph B Ford III PC

  • Psychologist
  • Traverse City, MI
National Provider Identifier
1891967238
Registry record updated Aug 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
RALPH B FORD III PC
Practice address
909 Gray Rd
Traverse City, MI 49686-9219
Phone
(231) 946-6235
Fax
(231) 946-1859
NPI assigned
Mar 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2008

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

Authorized official

Name
Dr. Ralph Ford III, ED.D.NPI 1821150277
Title
President
Phone
(231) 946-6235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

909 Gray Rd
Traverse City, MI 49686-9219

Mailing address

909 Gray Rd
Traverse City, MI 49686-9219
Phone (231) 946-6235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000826 MI Part B Supplier - Clinic/Group Practice 8123193083 Receives reassigned benefits from 1 practitioner
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218931200000",
    "number": "1891967238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 GRAY RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869219",
            "telephone_number": "231-946-6235",
            "fax_number": "231-946-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 GRAY RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869219",
            "telephone_number": "231-946-6235",
            "fax_number": "231-946-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH B FORD III PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-08-17",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-946-6235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.