Active NPI
Kayla Watts Ford
- Family Medicine Physician
- Jackson, MS
National Provider Identifier
1982454203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- T-5421
- Practice address
- 764 Lakeland Dr
Jackson, MS 39216-4651 - Phone
- (601) 984-6800
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | T-5421 | MS | Primary |
Addresses
Primary practice location
764 Lakeland Dr
Jackson, MS 39216-4651
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-1000
Other practice location 1
2466 Flowood Dr
Flowood, MS 39232-9019
Phone (601) 815-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241009001872 | MS | Order and Referring Only - Family Practice | 6305377748 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-5421 | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1982454203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "764 LAKELAND DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164651",
"telephone_number": "601-984-6800"
}
],
"practiceLocations": [
{
"address_1": "2466 Flowood Dr",
"address_purpose": "LOCATION",
"city": "Flowood",
"state": "MS",
"postal_code": "392329019",
"country_code": "US",
"telephone_number": "601-815-5700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORD",
"first_name": "KAYLA",
"middle_name": "WATTS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "T-5421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.