Individual provider Active NPI

John Elmer Forrette Jr., DPM

  • Podiatrist
  • Sioux Falls, SD
National Provider Identifier
1043216955
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
134 Issued in SD
Practice address
1210 W 18TH St
Sioux Falls, SD 57104-4647
Phone
(605) 328-1395
Fax
(605) 328-1898
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 134 SD Primary

Addresses

Primary practice location

1210 W 18TH St
Sioux Falls, SD 57104-4647

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9556

Other identifiers 1

IdentifierTypeStateIssuer
6800402MedicaidSD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
134SDMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1043216955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044647",
            "telephone_number": "605-328-1395",
            "fax_number": "605-328-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRETTE",
        "first_name": "JOHN",
        "middle_name": "ELMER",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SD",
            "license": "134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6800402",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.