KELLY E FORDYCE MD A MEDICAL CORPORATION
NPI 1831772417
Internal Medicine in Ladera Ranch, CA

Q: What is Kelly E Fordyce MD A Medical Corporation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 03, 2021

777 CORPORATE DR STE 140, LADERA RANCH, CA 92694(949) 409-4868(949) 409-4898 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 1, 2021, May 3, 2021 (2 updates tracked since 2021).

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About Kelly E Fordyce Md A Medical Corporation NPPES

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

KELLY E FORDYCE MD A MEDICAL CORPORATION (NPI 1831772417) is a healthcare organization registered as an internal medicine in Ladera Ranch, California and active in the NPI registry since May 2021. The organization lists Kelly E Fordyce, Owner, as its authorized official.

NPPES Registry Identity

NPI1831772417

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameKELLY E FORDYCE MD A MEDICAL CORPORATION

Location Address777 CORPORATE DR STE 140Ladera Ranch, CA 92694-2136

Mailing Address777 Corporate Dr Ste 140Ladera Ranch, CA 92694-2136 · (949) 409-4868 · Fax (949) 409-4898

Phone(949) 409-4868

Fax(949) 409-4898

Organization SubpartNo

Authorized OfficialKelly E FordyceOwner · (949) 573-8335

Enumeration DateMay 3, 2021

Last NPPES UpdateJune 1, 20212 updates tracked since enumeration

NPPES CertifiedJune 1, 2021

✔ NPI 1831772417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

777 CORPORATE DR STE 140, Ladera Ranch, CA 92694

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Other Identifiers 1

Medicaid00A732940CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly E Fordyce Md A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kelly E Fordyce MD A Medical Corporation, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Kelly Fordyce, M.D.

Internal Medicine

NPI 1477531481

26800 CROWN VALLEY PKWY SUITE 305
Mission Viejo, CA 92691

(949) 364-6000

✔ PECOS✔ Accepts Medicare2.2 mi

Roxanne Stallworth, M.D., M.P.H.

Internal Medicine

NPI 1366678906

1640 NEWPORT BLVD STE 440
Costa Mesa, CA 92627

(949) 791-8888

✔ PECOS✔ Accepts Medicare18 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kelly E Fordyce MD A Medical Corporation's NPI number?

The NPI number for Kelly E Fordyce MD A Medical Corporation is 1831772417. It was assigned to this organization in the NPPES registry on May 3, 2021.

Where is Kelly E Fordyce MD A Medical Corporation located?

Kelly E Fordyce MD A Medical Corporation is located at 777 Corporate Dr Ste 140, Ladera Ranch, CA 92694. The listed phone number is (949) 409-4868.

What is Kelly E Fordyce MD A Medical Corporation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kelly E Fordyce MD A Medical Corporation enrolled in Medicare?

Yes. Kelly E Fordyce MD A Medical Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kelly E Fordyce MD A Medical Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Kelly E Fordyce MD A Medical Corporation. A 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 the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kelly E Fordyce MD A Medical Corporation was last updated on June 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.