Michael William Fort, MD, MPH

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1 Medical Dr
Lebanon, NH 03756-1000

Phone

(603) 380-1302

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1174151336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-380-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ford, PMHNP
• Melissa Elaine Mott Ford, PA-C
• Shane K Ford, M.D.
• Stanwood Ford
• Lindsey Ann Forsyth, FNP-C
• Elizabeth Alice Foss
• Lauren Michelle Foss, PHARMD
• Jennifer Paige Fossett
• Amy W Foster Bosco, M.S., LGC
• Christin MB Foster, MD

• Student in an Organized Health Care Education/Training Program in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Student in an Organized Health Care Education/Training Program in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.