TANESHA FORD FNP
NPI 1063290534
Nurse Practitioner - Family in Prince George, VA
About Tanesha Ford Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TANESHA FORD FNP (NPI 1063290534) is an individual family provider in Prince George, Virginia, licensed in Virginia (0024187907) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, is affiliated with Bon Secours Southside Medical Center, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tanesha Ford Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Tanesha Ford reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Prince George, VA 23875
- Reassigned Medicare billing, Virginia enrollment
- Medicare enrollment name: Prime Care Family Practice PC
- 7 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bon Secours Southside Medical Center
Acute Care Hospitals · Petersburg, VAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 23875 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PRINCE GEORGE, VA 23875
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tanesha Ford's NPI number?
The NPI number for Tanesha Ford is 1063290534. It was assigned to this individual provider in the NPPES registry on September 18, 2023.
Where is Tanesha Ford located?
Tanesha Ford practices at 4700 Puddledock Rd Ste 300, Prince George, VA 23875. The listed phone number is (804) 526-1111.
What is Tanesha Ford's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Tanesha Ford enrolled in Medicare?
Yes. Tanesha Ford is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tanesha Ford's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tanesha Ford reassigns Medicare benefits to Prime Care Family Practice, P.C. (Prince George, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tanesha Ford's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Tanesha Ford affiliated with any hospitals?
According to CMS data, Tanesha Ford is affiliated with Bon Secours Southside Medical Center.
When was this NPI record last updated?
The NPPES record for Tanesha Ford was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tanesha Ford, FNP · NPI 1063290534
Family physician in Prince George, Virginia. Individual provider, active in the CMS NPPES registry since September 18, 2023.
## Identity
- **NPI:** 1063290534 (Entity type: Individual)
- **Enumerated:** September 18, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0024187907 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 4700 PUDDLEDOCK RD STE 300, Prince George, VA 23875-1268
- **Phone:** (804) 526-1111
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Prime Care Family Practice, P.C. (NPI 1881629384, Prince George, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** September 18, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1063290534) · Data from the CMS NPPES public registry.