Individual provider Active NPI

John W Forrest Jr., MD

  • Ophthalmology Physician
  • Gainesville, GA
National Provider Identifier
1083635726
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
023956 Issued in GA
Practice address
705 Jesse Jewell Pkwy SE
Ste 100
Gainesville, GA 30501-3868
Phone
(770) 532-9639
Fax
(770) 532-0753
NPI assigned
Jul 21, 2006
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 023956 GA Primary

Addresses

Primary practice location

705 Jesse Jewell Pkwy SE
Ste 100
Gainesville, GA 30501-3868

Mailing address

705 Jesse Jewell Pkwy SE
Ste 100
Gainesville, GA 30501-3867
Phone (770) 532-9639

Other identifiers 2

IdentifierTypeStateIssuer
180001313OtherGARAILROAD MCR
0528130001OtherGACIGNA GOVERNMENT SERVICES

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1083635726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 JESSE JEWELL PKWY SE",
            "address_2": "STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013867",
            "telephone_number": "770-532-9639",
            "fax_number": "770-532-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 JESSE JEWELL PKWY SE",
            "address_2": "STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013868",
            "telephone_number": "770-532-9639",
            "fax_number": "770-532-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "023956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "180001313",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "0528130001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.