Provider Demographics
NPI: | 1134427735 |
---|---|
Name: | FORD, JOSHUA WAYNE (RRT) |
Entity type: | Individual |
Prefix: | |
First Name: | JOSHUA |
Middle Name: | WAYNE |
Last Name: | FORD |
Suffix: | |
Gender: | M |
Credentials: | RRT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 8330 N SKILES AVE APT 332 |
Mailing Address - Street 2: | |
Mailing Address - City: | KANSAS CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64158-7142 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 816-294-7797 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1600 E EVERGREEN ST |
Practice Address - Street 2: | |
Practice Address - City: | CAMERON |
Practice Address - State: | MO |
Practice Address - Zip Code: | 64429-2400 |
Practice Address - Country: | US |
Practice Address - Phone: | 816-649-3284 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2011-03-05 |
Last Update Date: | 2011-03-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 2007035510 | 2278G0305X, 2278P3900X, 2279C0205X, 2279E0002X, 2279G1100X, 2279P1006X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
No | 2278G0305X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Geriatric Care |
No | 2278P3900X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Neonatal/Pediatrics |
No | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No | 2279E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Emergency Care |
No | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist |