Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. DONALD L FORDHAM M.D.
NPI 1477537470
Family Medicine in Demorest, GA

Q: What is Donald Fordham's NPI number?

The NPI number for Donald Fordham is 1477537470. It was assigned to this individual provider in the NPPES registry on December 2, 2005.

Q: What is Donald Fordham's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Fordham was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.

Active since December 02, 2005PECOS Enrolled

865 AUSTIN DR, DEMOREST, GA 30535(706) 754-8811(706) 754-8822 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Donald L Fordham M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DONALD L FORDHAM M.D. (NPI 1477537470) is an individual family medicine provider in Demorest, Georgia, licensed in Georgia (044718) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of University Of Alabama School Of Medicine (1995).

NPPES Registry Identity

NPI1477537470

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DONALD L FORDHAMCredential: M.D.

Location Address865 AUSTIN DRDemorest, GA 30535-4513

Mailing AddressPo Box 308Demorest, GA 30535-0308 · (706) 754-8811 · Fax (706) 754-8822

Phone(706) 754-8811

Fax(706) 754-8822

Sole ProprietorNo

Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1995

Enumeration DateDecember 2, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1477537470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 044718

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

865 AUSTIN DR, Demorest, GA 30535

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Donald L Fordham M.d. 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.

PECOS PAC ID1658383831

PECOS Enrollment IDI20060707000325

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

375 services198 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

326 services195 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

235 services203 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

211 services211 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

208 services208 patients

Hemoglobin a1c level, by device for home use 83037

A Hemoglobin A1c device for home use allows you to check your average blood sugar levels over the past 3 months. It's a simple, painless test that provides immediate results, helping you manage your diabetes more effectively.

181 services76 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

145 services141 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

67 services59 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

29 services28 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

27 services27 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

21 services21 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

17 services16 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Northeast Georgia Medical Center Habersham

Acute Care Hospitals · Demorest, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110041

Location541 Historic Highway 441-NorthDemorest, GA 30535 · Habersham County

Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30535 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Foot Exam

The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year

69%223 patients3/55-star benchmark: 98%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

91%223 patients4/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

33%487 patients2/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

94%487 patients5/55-star benchmark: 90%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

96%1,888 patients5/55-star benchmark: 96%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 1% · 487 patients

8%487 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers22 claims69 services$6.56 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers13 claims13 services$42.58 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

1 supplier12 claims70 services$21.49 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

1 supplier13 claims13 services$60.06 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

2 suppliers11 claims11 services$19.87 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers18 claims107 services$2.33 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELBY LEE PRITCHETT FNP-BC

Nurse Practitioner (Family)