Leeza Fortner

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

259 Mack Ave Ste 4514
Detroit, MI 48201-2427

Phone

(313) 577-4723

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1013514702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33708 LIPKE ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480353618",
            "telephone_number": "586-846-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MACK AVE STE 4514",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427",
            "telephone_number": "313-577-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "LEEZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gu9164@wayne.edu",
            "affiliation": "N",
            "endpointDescription": "Athletic Training Student",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "259 Mack Ave Ste 4514",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482012427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonathan E Forsberg, CRNA
• Jodee Forster
• Joann Forsythe, CRNA
• Joshua Forsythe, CPRC CPRM
• Isaiah Forte, CHW, AAB
• Cris Yolanda Fortson, MA., LLPC
• Elissa Kay Fory, M.D.
• Karmen Foshee-Reed
• Julie Ann Foss, OTR
• Foster Family Medical Equipment, Inc.

• Student in an Organized Health Care Education/Training Program in Detroit, MI
• Providers in Detroit, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.