Mark Fordham, CP

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

451 Ruin Creek Rd
Ste. 102
Henderson, NC 27536-2878

Phone

(252) 436-2611

NPI assigned

Jun 29, 2007

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• North Carolina Orthotics & Prosthetics

  • Prosthetic/Orthotic Supplier
  • Wake Forest, NC
  • NPI 1063556983
  NPD (past)
• North Carolina Orthotics & Prosthetics

  • Prosthetic/Orthotic Supplier
  • Henderson, NC
  • NPI 1427136845
  NPD (past)
• North Carolina Orthotics & Prosthetics of Roanoke Rapids, Inc

  • Prosthetic/Orthotic Supplier
  • Roanoke Rapids, NC
  • NPI 1114002847

  Prosthetist

  NPD (past)
• North Carolina Orthotics & Prosthetics of Rocky Mount, Inc

  • Customized Equipment (DME)
  • Rocky Mount, NC
  • NPI 1376830273
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1992902266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 RUIN CREEK RD",
            "address_2": "STE. 102",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362878",
            "telephone_number": "252-436-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 RUIN CREEK RD",
            "address_2": "STE. 102",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362878",
            "telephone_number": "252-436-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "MARK",
        "credential": "CP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7795152",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wayne Alexander Fonvielle III, M.A.
• Food Lion LLC (Food Lion Pharmacy #1228)
• Food Lion, LLC (Food Lion Pharmacy #1660)
• Foot and Ankle Specialists of the Mid-Atlantic, LLC
• Michelle Ford, BA, PSYCHOLOGY
• Four County Eye Associates
• Four County Primary Care, RLLP
• Four County Psychological Associates, PA
• Drew Frankenfield
• Franklin-Granville-Vance Partnership for Children (Smart Start)

• Prosthetist in Henderson, NC
• Providers in Henderson, NC by specialty
• Prosthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.