Evey Fortin LMT LLC

Key facts

NPI

1215769484

Entity type

Organization (NPI type 2)

Primary specialty

Mechanotherapist 172M00000X

Legal business name

EVEY FORTIN LMT LLC

Practice address

2863 E Millennium Dr
Fayetteville, AR 72703-6513

Phone

(479) 444-7332

NPI assigned

Aug 16, 2024

Organization subpart

No

Authorized official

Name

Yvonne (Evey) Fortin, LMT

Title

Owner

Phone

(479) 422-7895

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Cole Fennel, DC Chiropractor · Fayetteville, AR · NPI 1265305684
  NPD SINGLE SPECIALTY
• Yvonne Fortin, LMT Mechanotherapist · Fayetteville, AR · NPI 1841065034
  NPD MECHANOTHERAPIST

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Evey Fortin LMT Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 16, 2024.

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1215769484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 MADISON 6001",
            "city": "ELKINS",
            "state": "AR",
            "postal_code": "727278492",
            "telephone_number": "479-422-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 E MILLENNIUM DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036513",
            "telephone_number": "479-444-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEY FORTIN LMT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "FORTIN",
        "authorized_official_first_name": "YVONNE (EVEY)",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-422-7895",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evey Fortin LMT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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