Millicent Booker Ford, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200401028 Issued in NC

Practice address

2933 Maplewood Ave
Winston Salem, NC 27103-4001

Phone

(336) 794-3380

Fax

(336) 794-3378

NPI assigned

Jul 14, 2006

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

Other identifiers 1

Other names 1

• Millicent Candene Booker Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mford2754338@carolinashealthcaresystem.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.

• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment NPD
• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Winston Salem, NC
  • NPI 1063647394
  NPD
• Wake Forest Health Network, LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD
• Wake Forest Health Network LLC

  • Family Medicine Physician
  • Granite Falls, NC
  • NPI 1770858938
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Lexington, NC
  • NPI 1639454499
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1912923905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-702-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034001",
            "telephone_number": "336-794-3380",
            "fax_number": "336-794-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272926768",
            "country_code": "US",
            "telephone_number": "336-249-4911",
            "fax_number": "336-249-1782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "MILLICENT",
        "middle_name": "BOOKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200401028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89138AX",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLICENT",
            "last_name": "BOOKER",
            "middle_name": "CANDENE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cameon Ford, PA-C
• Cameron Grant Ford, PHD
• Jennifer Lauren Ford, LCSW
• Kimberly Renee' Ford, LCMHC, LPC, LCAS-A
• Kristy Kester Ford, MD
• Robert Ford Jr., M.D.
• Ford, Simpson, Lively & Rice Pediatrics
• Lovinia Page Foreman Abernethy, CRNA
• Arthur Foreman, MD
• Daniel Jordan Forest, M.D.

• Pediatrics Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.