Active NPI
Elizabeth D Forrest, MD
- Internal Medicine Physician
- Chesapeake, VA
National Provider Identifier
1073577300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101042209
- Practice address
- 4020 Raintree Rd
Suite B
Chesapeake, VA 23321-3749 - Phone
- (757) 686-5673
- Fax
- (757) 489-0485
- NPI assigned
- Apr 13, 2006
- Last updated
- Feb 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101042209 | VA | Primary |
Addresses
Primary practice location
4020 Raintree Rd
Suite B
Chesapeake, VA 23321-3749
Mailing address
4020 Raintree Rd
Suite B
Chesapeake, VA 23321-3749
Phone (757) 686-5673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5806135 | Medicaid | VA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101042209 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryview Hospital LLC | Past | Accepting new patients | |
| Maryview Hospital | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Chesapeake, VA
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-
dba Bon Secours Liver Institute of Hampton Roads
- Gastroenterology Physician
- Newport News, VA
- NPI 1013439835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1073577300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 RAINTREE RD",
"address_2": "SUITE B",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233213749",
"telephone_number": "757-686-5673",
"fax_number": "757-489-0485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 RAINTREE RD",
"address_2": "SUITE B",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233213749",
"telephone_number": "757-686-5673",
"fax_number": "757-489-0485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORREST",
"first_name": "ELIZABETH",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-13",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101042209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5806135",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.