Active NPI
Jessica Lynn Fornieri, ATC
- Specialist
- Washington, DC
National Provider Identifier
1215390331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- LAT-2710
- Practice address
- 3700 O St NW
Washington, DC 20057-0002 - Phone
- (202) 687-6674
- NPI assigned
- Apr 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | LAT-2710 | NC | Primary |
Addresses
Primary practice location
3700 O St NW
Washington, DC 20057-0002
Mailing address
964 Manor LN
Bay Shore, NY 11706-7506
Phone (631) 456-1330
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-2710 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1215390331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "964 MANOR LN",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117067506",
"telephone_number": "631-456-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 O ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200570002",
"telephone_number": "202-687-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNIERI",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-05",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "LAT-2710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.