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Deactivated NPI 1114077401 Deactivated / Inactive NPI Male Practitioner

Casey Lee Fordham , R MR

Radiologic Technologist • Macon, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Casey Fordham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 11, 2007
NPI Deactivation Date May 28, 2026
Total Practice Duration ~19 Years of Practice (2007 – 2026)

Professional Overview & Biography Verified Profile Summary

Casey Fordham, R MR was a registered Radiologic Technologist practicing in Macon, GA. Throughout an active medical career spanning 19 years, Casey Fordham provided care at the practice location at 1504 HARDEMAN AVE until profile deactivation on 2026-05-28.

Practice Location & Contact Primary Location

Practice Address

1504 Hardeman Ave

Macon, GA 312011416

Telephone 4787453135
Associated Practice Facility / Clinic
🏢 Physicians Mri Inc Facility NPI 1730158601

Specialty Benchmarks & Practice Insights

Comparative analytics for Radiologic Technologist in Macon, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Macon, GA (35 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Radiologic Technologist Primary Specialty

NUCC Taxonomy Code: 247100000X

State License None 347107

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Tricia Mizell , RT (R) (ARRT)

Radiologic Technologist

NPI 1083951867

RT(R)(ARRT)

Judy Cooper , R, MR

Radiologic Technologist - Magnetic Resonance Imaging

NPI 1275544652
Russell Gibson , MR

Radiologic Technologist - Magnetic Resonance Imaging

NPI 1538479043
Christopher Harris , R, MR

Radiologic Technologist - Magnetic Resonance Imaging

NPI 1568473957
Ashley Radford , RT (R) (CT) (MR)

Radiologic Technologist - Magnetic Resonance Imaging

NPI 1679812432

RT(R)(CT)(MR)

Deborah Kovalick-Leggett , R

Radiologic Technologist - Radiography

NPI 1801807201

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 28, 2026

Record deactivated on May 28, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1504 HARDEMAN AVE, MACON, GA 312011416 (Tel: 4787453135)

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Updated Business Mailing Address July 08, 2007

Registered at 219 LAKE LILLIAN DR, PERRY, GA 310699789 (Tel: 4789889701)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CASEY FORDHAM, R MR

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Radiologic Technologist (License #347107 in None)

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Initial NPI Registration & Enumeration January 11, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114077401
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 11, 2007
Last Update: July 08, 2007
Deactivation Date: May 28, 2026

Mailing Address

219 Lake Lillian Dr

Perry, GA 310699789

Phone: 4789889701

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.