TANESHA FORD (FNP) – Family Nurse Practitioner, NPI 1063290534

TANESHA FORD (FNP) is a healthcare provider. based in Prince george, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 0024187907 (VA). The NPI Number for TANESHA FORD (FNP) is 1063290534

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
TANESHA FORD (FNP)
NPI
1063290534
Phone
Not provided
Address
4700 PUDDLEDOCK RD STE 300
Enumeration Date
18 September 2023
Last Update Date
18 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8045261111122
Graduation Year
2023 (3 years ago)
PAC ID
1052817780
Group Practice PAC ID
5799738035
Professional Enrollment ID
I20251001004310
Address ID
VA238751268PR4700XRDXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for TANESHA FORD (FNP)

  • 4700 PUDDLEDOCK RD STE 300

    PRINCE GEORGE, VA 238751268

    Phone:

    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)

CMS reports 28 Open Payments records for all available years, with a total value of $1,537.

Total Amount is formed as General ($1,537) + Research ($0) + Ownership ($0) = $1,537.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($365).

Total Amount

$1,537

General + Research + Ownership

Payments

28

Total payment records

General Amount

$1,537

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-10-01

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
I20251001004310INurse PractitionerVATBD

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 23875)

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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: 5799738035View full group profile
NameSpecialtyState
Family PracticeVA
Family PracticeVA
Nurse PractitionerVA
Family PracticeVA
Family PracticeVA
Nurse PractitionerVA

Reviews

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Frequently asked questions

Is TANESHA FORD (FNP) listed with a National Provider Identifier?
Yes — TANESHA FORD (FNP) has NPI 1063290534 on file in the registry.
Is TANESHA FORD (FNP) still an active registrant?
TANESHA FORD (FNP) carries an active NPI according to the public dataset.
What kind of doctor is TANESHA FORD (FNP)?
TANESHA FORD (FNP) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is TANESHA FORD (FNP) located near Prince George?
TANESHA FORD (FNP) currently maps to Prince George, Virginia in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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