Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kandis Danielle Fordham, PA-C

Individual provider Physician Assistant · NPI 1417467408

Kandis Danielle Fordham, PA-C is a Physician Assistant in Fayetteville, North Carolina. Qualified in 2017, 9 years ago. Works from 2 locations. Licensed in North Carolina.

Years since qualifying
9
Licensed in
NC
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

556 Sandhurst Dr
Fayetteville, NC 28304-4426
Phone: (910) 483-2646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1095 N Bragg Blvd Ste 104, Spring Lake, NC 28390-3307 — (910) 339-6015

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-07636 (NC)
Adult Medicine Physician Taxonomy 207QA0505X · Licence 0010-07636 (NC)

Record details

NPI number1417467408
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 4, 2017
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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