Organization Active NPI

Fortney Therapeutics PLC

  • Clinical Psychologist
  • Melbourne, FL
National Provider Identifier
1063717908
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8142 Issued in FL
Legal business name
FORTNEY THERAPEUTICS PLC
Doing business as
Dr. Tim Fortney
Practice address
100 Rialto PL
Suite 754
Melbourne, FL 32901-3055
Phone
(321) 728-9620
NPI assigned
Jan 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Authorized official

Name
Dr. Timothy Fortney, PSY.D.
Title
Psychologist
Phone
(239) 443-0498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY8142 FL Primary

Addresses

Primary practice location

100 Rialto PL
Suite 754
Melbourne, FL 32901-3055

Mailing address

2760 Gray Fox LN
Orlando, FL 32826-3693
Phone (239) 443-0498

Other names 1

  • Dr. Tim Fortney Doing business as

National Provider Directory

National Provider Directory

Locations

100 Rialto Pl
Ste 754
Melbourne, FL 32901
Phone (321) 728-9620

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1063717908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 GRAY FOX LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328263693",
            "telephone_number": "239-443-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIALTO PL",
            "address_2": "SUITE 754",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013055",
            "telephone_number": "321-728-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTNEY THERAPEUTICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "FORTNEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "239-443-0498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Tim Fortney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.