Active NPI
Darron E Forrest, PA
- Surgical Physician Assistant
- Montgomery, AL
National Provider Identifier
1124065222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA.16
- Practice address
- 273 Winton M Blount Loop
Montgomery, AL 36117-3507 - Phone
- (334) 280-1500
- Fax
- (334) 280-1611
- NPI assigned
- May 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA.16 | AL | Primary |
Addresses
Primary practice location
273 Winton M Blount Loop
Montgomery, AL 36117-3507
Mailing address
273 Winton M Blount Loop
Montgomery, AL 36117-3507
Phone (334) 280-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA-16 | Other | AL | PHYSICIAN ASSISTANT |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.16 | AL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Medical Associates of Georgia LLC | Past | Accepting new patients | |
| Thoracic Cardiac & Vascular Surgery | 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 and National Provider Directory roles.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Birmingham, AL
- NPI 1164432852
-
- Nephrology Physician
- Hermiston, OR
- NPI 1093775645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422835200000",
"number": "1124065222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 WINTON M BLOUNT LOOP",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361173507",
"telephone_number": "334-280-1500",
"fax_number": "334-280-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 WINTON M BLOUNT LOOP",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361173507",
"telephone_number": "334-280-1500",
"fax_number": "334-280-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORREST",
"first_name": "DARRON",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2015-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "AL",
"license": "PA.16",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN ASSISTANT",
"identifier": "PA-16",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.