DR. BAIN C FORD (PSY.D.) – Clinical Psychologist, NPI 1043520679

DR. BAIN C FORD (PSY.D.) is a healthcare provider. based in Springfield, Virginia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 0810004320 (VA). The NPI Number for DR. BAIN C FORD (PSY.D.) is 1043520679

Main info

Male
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
DR. BAIN C FORD (PSY.D.)
NPI
1043520679
Phone
(703) 569-8731
Address
8134 OLD KEENE MILL RD
Enumeration Date
17 October 2010
Last Update Date
17 October 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7035698731214
Graduation Year
2009 (17 years ago)
PAC ID
0244417053
Group Practice PAC ID
1254496888
Professional Enrollment ID
I20110603000365
Address ID
VA221521849SP8134XRDXX501
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

667 CLINICAL PSYCHOLOGIST in VA

Provider Addresses for DR. BAIN C FORD (PSY.D.)

  • 8134 OLD KEENE MILL RD

    SUITE 101

    SPRINGFIELD, VA 221521800

    Phone: (703) 569-8731

    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: 2011-06-03

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
I20110603000365IClinical PsychologistDCTBD

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 22152)

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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: 1254496888View full group profile
NameSpecialtyState
Clinical PsychologistVA
Clinical PsychologistVA
Clinical PsychologistDC
Mental Health CounselorVA
Clinical PsychologistVA
Clinical PsychologistVA
Mental Health CounselorVA
Clinical PsychologistVA
Mental Health CounselorVA
Clinical PsychologistVA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. BAIN C FORD (PSY.D.)'s NPI?
Yes. DR. BAIN C FORD (PSY.D.) is listed with NPI 1043520679 in the public NPI dataset.
Is DR. BAIN C FORD (PSY.D.) still practicing?
DR. BAIN C FORD (PSY.D.) is currently listed as active in the public NPI registry.
What is DR. BAIN C FORD (PSY.D.)'s primary classification?
Clinical Psychologist is the headline specialty for DR. BAIN C FORD (PSY.D.) here. Clinical services aligned with this taxonomy classification.
What area does DR. BAIN C FORD (PSY.D.) serve?
DR. BAIN C FORD (PSY.D.)'s listing highlights Springfield, Virginia; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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