Edwin J Fortenbery, MD

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

045221 Issued in GA

Practice address

417 W 3Rd Ave
Albany, GA 31701-1943

Phone

(706) 653-1088

Fax

(706) 653-1162

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464

  AL

  Medicare reassignment NPD
• Phoebe Senior Center

  • Clinic/Center
  • Camilla, GA
  • NPI 1821394271
  NPD
• Quantum Medical Radiology PC

  • Diagnostic Radiology Physician
  • Smyrna, GA
  • NPI 1164475869
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073596789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1828",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317021828",
            "telephone_number": "706-653-1088",
            "fax_number": "706-653-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "706-653-1088",
            "fax_number": "706-653-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERY",
        "first_name": "EDWIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "045221",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "045221",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "045221",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "045221",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "GA",
            "license": "045221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "52584721 013",
            "identifier": "BCBS",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Focused Home Care Services LLC
• Foenix Rehabilitation LLC
• Brittany Ford
• Patricia Carol Ford, FNP-C
• Yteela K. Ford
• Nedra S Fortson, AGPCNP-BC, RN
• Carolyn Fowler, PA
• Michael Anthony Fowler, PAC MPAS
• Tynik Lenessa Fox, PT
• Kari L Fralish, NP

• Nuclear Radiology Physician in Albany, GA
• Providers in Albany, GA by specialty
• Nuclear Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.