Individual provider Active NPI

Robert Samuel Forsythe, DC

  • Chiropractor
  • Dover, NH
National Provider Identifier
1104956903
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
281-0397 Issued in NH
Practice address
15 Weeks LN
Dover, NH 03820-2500
Phone
(603) 742-2216
Fax
(603) 743-3748
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 281-0397 NH Primary

Addresses

Primary practice location

15 Weeks LN
Dover, NH 03820-2500

Mailing address

15 Weeks LN
Dover, NH 03820-2500
Phone (603) 742-2216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060215000094 NH Practitioner - Chiropractic 2567477391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somersworth Chiropractic Professional AssnGroup PAC ID 6204871890, 2 clinicians

Practice addresses (Care Compare)

339 High St
Somersworth, NH 03878-1415
Phone (603) 692-2376

339 High St
Somersworth, NH 03878-1497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104956903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WEEKS LN",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202500",
            "telephone_number": "603-742-2216",
            "fax_number": "603-743-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WEEKS LN",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202500",
            "telephone_number": "603-742-2216",
            "fax_number": "603-743-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTHE",
        "first_name": "ROBERT",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "281-0397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.