Theresa Maureen Fortin, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024164891 Issued in VA

Practice address

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Phone

(804) 675-5000

Fax

(804) 675-5847

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJEFCA/Endpoint/BJEFCA

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013948264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9280 HANOVER CROSSING DR APT D",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163930",
            "telephone_number": "804-427-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5000",
            "fax_number": "804-675-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "THERESA",
        "middle_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Blair Forsyth, PA-C
• Mary Ann Fort, R.PH.
• Anyinkia Forteh, CRNP
• Richard Forth, ARNP
• David E Fortin
• Nyemkuna Fortingo, MD
• Sharon Matthews Fortune, LPC, CSAC
• Forward Futures Health LLC
• Forward Pathology Solutions LLC
• Forward Pathology Solutions LLC

• Family Nurse Practitioner in Richmond, VA
• Providers in Richmond, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.