Johnnethel M Fort, OTR/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

OT10738 Issued in FL

Practice address

8495 Normandy Blvd
Jacksonville, FL 32221-6701

Phone

(904) 783-3749

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1184066771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 PEBBLE RIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322201323",
            "telephone_number": "904-343-1441",
            "fax_number": "904-786-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322216701",
            "telephone_number": "904-783-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "JOHNNETHEL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "FL",
            "license": "OT10738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Forster, APRN
• Robert J Forster, MD
• Fort Caroline Clinic of Chiropractic
• Fort Caroline Clinic of Chiropractic
• Fort Caroline Gardens
• Kathleen Frank Fort, APRN
• Peter Anthony Fort, D.C
• Adria Pratt Forte, LMHC
• Antonio Forte, MD
• Debra Ann Forte, CRNA

• Gerontology Occupational Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Gerontology Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.