MRS. JENNIFER YVONNE FORD (NP) – Nurse Practitioner, NPI 1174327357

MRS. JENNIFER YVONNE FORD (NP) is a healthcare provider. based in Villa rica, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. APRN-NP137808 (GA). The NPI Number for MRS. JENNIFER YVONNE FORD (NP) is 1174327357

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JENNIFER YVONNE FORD (NP)
NPI
1174327357
Phone
(770) 836-9445
Address
101 QUARTZ DR STE 101
Enumeration Date
4 April 2025
Last Update Date
10 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7709497500
Graduation Year
2024 (2 years ago)
PAC ID
1951825785
Group Practice PAC ID
9133105976
Professional Enrollment ID
I20250414001562
Address ID
GA301803252VI101XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MRS. JENNIFER YVONNE FORD (NP)

  • 101 QUARTZ DR STE 101

    VILLA RICA, GA 301803256

    Phone: (770) 836-9445

    Fax: (770) 836-8808

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-04-14

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250414001562INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30180)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133105976View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerAL
Nurse PractitionerGA
Family PracticeGA
Nurse PractitionerGA
Nurse PractitionerGA
Family PracticeMI
-GA
Nurse PractitionerGA
General Practice, Pediatric MedicineWV

Reviews

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Frequently asked questions

What is the 10-digit NPI for MRS. JENNIFER YVONNE FORD (NP)?
MRS. JENNIFER YVONNE FORD (NP) — NPI 1174327357 — is the standard way to identify this listing.
Is MRS. JENNIFER YVONNE FORD (NP) still practicing?
MRS. JENNIFER YVONNE FORD (NP) is currently listed as active in the public NPI registry.
What healthcare role does MRS. JENNIFER YVONNE FORD (NP) hold?
Scheduling teams often label MRS. JENNIFER YVONNE FORD (NP) under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MRS. JENNIFER YVONNE FORD (NP) list a practice location?
Patients near Villa Rica, Georgia may find MRS. JENNIFER YVONNE FORD (NP) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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