Individual provider Active NPI

Mary C. Forbus, CRNA

  • Certified Registered Nurse Anesthetist
  • Alexander City, AL
National Provider Identifier
1003836925
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1022524 Issued in AL
Practice address
3316 Highway 280
Alexander City, AL 35010-3369
Phone
(256) 329-7120
Fax
(256) 329-7600
NPI assigned
Jul 21, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1022524 AL Primary

Addresses

Primary practice location

3316 Highway 280
Alexander City, AL 35010-3369

Mailing address

98 Eiland Dr
Alexander City, AL 35010-9076
Phone (256) 825-2662

Other identifiers 1

IdentifierTypeStateIssuer
51071557OtherALBLUE CROSS PROVIDER NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1022524ALMDCertified Registered Nurse Anesthetist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003836925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 EILAND DR",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350109076",
            "telephone_number": "256-825-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 HIGHWAY 280",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103369",
            "telephone_number": "256-329-7120",
            "fax_number": "256-329-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBUS",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1022524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "51071557",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexander City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.