DR. DEREK FORD (PHD) – Counselor, NPI 1871871822

DR. DEREK FORD (PHD) is a healthcare provider. based in Hazard, Kentucky. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 0810006969 (VA). The NPI Number for DR. DEREK FORD (PHD) is 1871871822

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. DEREK FORD (PHD)
NPI
1871871822
Phone
(606) 436-5761
Address
115 ROCKWOOD LN
Enumeration Date
25 July 2011
Last Update Date
22 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5404332858
Graduation Year
2012 (14 years ago)
PAC ID
4688065675
Group Practice PAC ID
5890949580
Professional Enrollment ID
I20211230000664
Address ID
VA228013429HA312XXAVEX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:14State licenses:1Digital endpointsOther names

253 CLINICAL PSYCHOLOGIST in KY

Provider Addresses for DR. DEREK FORD (PHD)

  • 115 ROCKWOOD LN

    HAZARD, KY 417019415

    Phone: (606) 436-5761

    Fax: (606) 435-0817

    Type: Mailing

  • 312 NEFF AVE

    HARRISONBURG, VA 228013429

    Phone: (540) 433-2858

    Fax: (540) 433-1175

    Type: Mailing

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: 2021-12-30

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
I20211230000664IClinical PsychologistVATBD

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 41701)

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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: 5890949580View full group profile
NameSpecialtyState
Clinical PsychologistVA
Clinical PsychologistVA
-VA
Clinical PsychologistVA

Reviews

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Frequently asked questions

What is the standard ID for DR. DEREK FORD (PHD) in the U.S.?
In the U.S., DR. DEREK FORD (PHD) is identified by NPI 1871871822.
Is DR. DEREK FORD (PHD) currently accepting referrals based on NPI status?
Registry metadata lists DR. DEREK FORD (PHD) as active.
How should patients interpret DR. DEREK FORD (PHD)'s specialty?
The extract shows Counselor for DR. DEREK FORD (PHD). Clinical services aligned with this taxonomy classification.
Which community is linked to DR. DEREK FORD (PHD)?
DR. DEREK FORD (PHD) shows a connection to Hazard, Kentucky in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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