KELLY FORD (NPI# 1760826788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760826788 |
| Entity Type | Individual |
| Full Name | KELLY FORD |
| Other Name | KELLY WAGNER |
| Credential | MD |
| Practice Address |
7695 Poplar Pike Ste 101 Germantown TN 38138-5947 |
| Practice Telephone | 9016852696 |
| Practice Fax Number | 9016829747 |
| Mailing Telephone | 9016852696 |
| Mailing Fax Number | 9016829747 |
| Enumeration Date | 2013-04-21 |
| Last Update Date | 2019-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
25927 | MS | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
56815 | TN | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
25927 | MS | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
56815 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598388522 | Kelly E Ford | Registered Nurse | 382 Hillsdale Cir, Wadsworth, OH 44281-1008 | 2020-05-26 |
| 1861753576 | Kelly Nicole Ford | Social Worker | 5157 Business 220, Bedford, PA 15522 | 2012-05-30 |
| 1093948622 | Kelly Ford | Specialist/Technologist, Other | 2200 E Parrish Ave., Bldg B, Ste 203, Owensboro, KY 42303 | 2009-08-31 |
| 1891342523 | Kelly Ford | Behavior Technician | 109 Oak St Ste 103, Newton, MA 02464-1493 | 2019-08-19 |
| 1407325426 | Kelly Nicole Ford | Physical Therapy Assistant | 1893 Ne Miami Gardens Dr, Miami, FL 33179-5035 | 2018-11-20 |
| 1568918621 | Kelly Ford | Counselor | 720 Se Washington St, Hillsboro, OR 97123-4230 | 2016-08-29 |
| 1013378363 | Kelly Ford | Counselor | 4923 Main St, Downers Grove, IL 60515-3654 | 2016-03-15 |
| 1205268604 | Kelly T Ford | Social Worker | 5 Linsley St, North Haven, CT 06473-2518 | 2013-08-07 |
| 1851669196 | Kelly Ann Ford | Physical Therapist | 300 Wyoming Ave, Wyoming, PA 18644-1695 | 2011-12-01 |
| 1083842462 | Kelly Ford | Counselor | 4550 E Bell Rd, 147, Phoenix, AZ 85032-9306 | 2009-06-24 |
| Street Address |
7695 POPLAR PIKE STE 101 |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38138-5947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700220050 | Jacqueline Angel | Radiology | 7695 Poplar Pike Ste 101, Germantown, TN 38138-5947 | 2013-04-17 |
| 1154764462 | Christopher Bates | Radiology | 7695 Poplar Pike Ste 101, Germantown, TN 38138-5947 | 2013-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382281 | Bluff Medical Group | Nurse Practitioner | 1779 Kirby Parkway, Suite 1-212, Germantown, TN 38138 | 2020-10-07 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1386102796 | Moscow Group LLC | Pharmacy | 2013 Exeter Rd, Germantown, TN 38138 | 2019-03-05 |
| 1952811010 | Select | Counselor | 9045 Forest Centre Dr Ste 102, Germantown, TN 38138 | 2017-10-03 |
| 1033638994 | 901 Physical Therapy, Pllc | Physical Therapist | 2495 Regents Walk, Germantown, TN 38138 | 2017-09-12 |
| 1124552401 | Elite Dental Germantown Plc | Dentist | 9064 Corporate Gradens Drive, Germantown, TN 38138 | 2017-04-13 |
| 1740728880 | Christian C Haynes | Nurse Anesthetist, Certified Registered | 1900 Exeter Rd., Suite 210, Germantown, TN 38138 | 2017-02-09 |
| 1740644004 | Kimberly Brooke Scheidegger | Counselor | 9045 Forest Centre Way, Heartlife Professional Soul Care, Germantown, TN 38138 | 2016-04-12 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1952761876 | Jane Chin Wynn Yeoh | Orthopaedic Surgery | 1400 South Germantown Road, Germantown, TN 38138 | 2016-03-04 |
| Find all providers in zip 38138 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871931667 | Sam Wairiri | Radiology | 1458 Grove Meadow Ct, Germantown, TN 38138-3307 | 2013-06-13 |
| 1811158967 | Reem Saadeh Awwad | Radiology | 8692 Somerset Ln, Germantown, TN 38138-7309 | 2008-06-20 |
| 1639369531 | Diagnostic Ultrasound Consultants | Radiology | 1300 Wolf Park Dr, Germantown, TN 38138-1741 | 2007-07-26 |
| 1194752683 | Richard Otto Wagner | Radiology | N116w17866 Blackstone Cir, Germantown, WI 53022-5665 | 2006-06-28 |
| 1528012119 | Germantown Outpatient Imaging, LLC | Radiology | 19731 Germantown Rd, Suite 102, Germantown, MD 20874-1203 | 2006-05-19 |
| 1518954759 | Gregory J S Lewis | Radiology | 7600 Wolf River Blvd, Ste 200, Germantown, TN 38138 | 2005-10-03 |
| 1114920394 | Jennifer R Boals | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-23 |
| 1578566741 | Robert L Cockroft | Radiology | 2683 Forest Hill Irene Rd, Germantown, TN 38139-7805 | 2005-05-23 |
| 1912395708 | West Tennessee Imaging, LLC | Radiology | 7600 Wolf River Blvd, Suite 100, Germantown, TN 38138-1744 | 2014-12-31 |
| 1154764462 | Christopher Bates | Radiology | 7695 Poplar Pike Ste 101, Germantown, TN 38138-5947 | 2013-04-17 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 38138 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.