Active NPI
Thomas P Fortune, MD
- Nephrology Physician
- Fredericksburg, VA
National Provider Identifier
1134223274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 010103908
- Practice address
- 101 Park Hill Drive
Fredericksburg, VA 22401 - Phone
- (540) 371-3010
- Fax
- (540) 899-9821
- NPI assigned
- Sep 11, 2006
- Last updated
- Nov 13, 2008
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 010103908 | VA | Primary |
Addresses
Primary practice location
101 Park Hill Drive
Fredericksburg, VA 22401
Mailing address
101 Park Hill Drive
Fredericksburg, VA 22401
Phone (540) 371-3010
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006037402 | Medicaid | VA | |
| 110026872 | Other | VA | RAILROAD |
| 00414802 | Other | VA | AETNA |
| 094197 | Other | VA | ANTHEM BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010103908 | VA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226534400000",
"number": "1134223274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 PARK HILL DRIVE",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22401",
"telephone_number": "540-371-3010",
"fax_number": "540-899-9821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 PARK HILL DRIVE",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22401",
"telephone_number": "540-371-3010",
"fax_number": "540-899-9821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNE",
"first_name": "THOMAS",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-11",
"last_updated": "2008-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "VA",
"license": "010103908",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006037402",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "110026872",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "00414802",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "094197",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.