MR. WILLIAM CHESTER JR. FORD (NP-C) – Family Nurse Practitioner, NPI 1124006200
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. WILLIAM CHESTER JR. FORD (NP-C)
5555 E PAMELA DR
WASILLA, AK 996540552
Phone: (706) 498-2361
Type: Mailing
11973, Augusta Road, Lavonia, Franklin County, Georgia, 30553, United States
LAVONIA, GA 305531283
Phone: (706) 356-8181
Fax: (706) 356-8081
Type: Location
1124006200
829 CHIEF EDDIE HOFFMAN HWY
BETHEL, AK 99559
Phone: (907) 543-6430
Type: Location
Tanglewood Drive, Royston, Franklin County, Georgia, 30662, United States
ROYSTON, GA 306623799
Phone: (706) 356-8181
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $35.
Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.
Last reported payment date: 2023-02-02 • Largest payer in this snapshot: Masimo Corporation ($35).
Total Amount
$35
General + Research + Ownership
Payments
2
Total payment records
General Amount
$35
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Masimo Corporation | $35 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-09-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040928000714 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99654)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AK | |
| - | AK | |
| - | WI | |
| - | AK | |
| - | MA | |
| - | AK | |
| - | AK | |
| - | AK | |
| - | AK | |
| - | AK |
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