Individual provider Active NPI

John Eric Fortenberry, M.D.

  • Emergency Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1083693345
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G72510 Issued in CA
Practice address
400 Old River Rd
Bakersfield, CA 93311-9781
Phone
(661) 326-8021
Fax
(661) 326-8022
NPI assigned
Jan 13, 2006
Last updated
Jan 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G72510 CA Primary

Addresses

Primary practice location

400 Old River Rd
Bakersfield, CA 93311-9781

Mailing address

15708 Tradition CT
Bakersfield, CA 93314-7871
Phone (661) 588-0758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130516000527 FL Practitioner - Emergency Medicine 1850374919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G72510CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Central California Hospitalists Current Accepting new patients
Central California Emergency Medicine Physicians Emergency Medicine Past Accepting new patients
Blue Job Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Bakersfield Emergency Medical Corp. Emergency Medicine Past Accepting new patients
Aw Pathology Medical Group, Inc. Past Accepting new patients

Locations

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

200 Tequesta Dr
Destin, FL 32541
Phone (850) 837-9194

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 6

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1083693345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15708 TRADITION CT",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933147871",
            "telephone_number": "661-588-0758",
            "fax_number": "661-588-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD RIVER RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119781",
            "telephone_number": "661-326-8021",
            "fax_number": "661-326-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G72510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.