NPIMap

Organization Active NPI

Tabitha B. Fortt, M.D., LLC

  • Primary Care Clinic/Center
  • Stamford, CT
National Provider Identifier
1235597741
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
037894 Issued in CT
Legal business name
TABITHA B. FORTT, M.D., LLC
Practice address
37 Glenbrook Rd
Suite #3
Stamford, CT 06902-2913
Phone
(203) 674-0774
Fax
(203) 674-0766
NPI assigned
Jan 29, 2016
Last updated
Feb 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Dr. Tabitha B Fortt, M.D.NPI 1427050426
Title
Member/Manager
Phone
(203) 674-0774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 037894 CT Primary

Addresses

Primary practice location

37 Glenbrook Rd
Suite #3
Stamford, CT 06902-2913

Mailing address

37 Glenbrook Rd
Suite #3
Stamford, CT 06902-2913
Phone (203) 674-0774

Other identifiers 1

IdentifierTypeStateIssuer
008036735MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1235597741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 GLENBROOK RD",
            "address_2": "SUITE #3",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022913",
            "telephone_number": "203-674-0774",
            "fax_number": "203-674-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 GLENBROOK RD",
            "address_2": "SUITE #3",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022913",
            "telephone_number": "203-674-0774",
            "fax_number": "203-674-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABITHA B. FORTT, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "FORTT",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "203-674-0774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "037894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008036735",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.