Michael A. Fortune, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD14008 Issued in OR

Practice address

3600 NW Samaritan Dr
Good Samaritan Regional Medical Center
Corvallis, OR 97330-3737

Phone

(541) 768-5572

Fax

(541) 768-5047

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1053430645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7635 NW MCDONALD CIR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "address_2": "GOOD SAMARITAN REGIONAL MEDICAL CENTER",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-5572",
            "fax_number": "541-768-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD14008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060186",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Amalie Fontenot, PSYD
• Christina Ford, RMA
• Joshua Forrest
• Sharon Lee Forster-Blouin, DVM
• Linda Frances Fortune, RN MN PMHNP
• Kyle Fosdick
• Dawn Alexandra Foss, MSOT, OTR/L
• Barbara Anne Foster-Macal, RPH
• Kevin Foster, PT
• Chris Foulke

• Anatomic Pathology & Clinical Pathology Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.