Lee a Forestiere MD PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

C4813 Issued in AR

Legal business name

LEE A FORESTIERE MD PA

Practice address

1609 W 40TH Ave Ste 403
Pine Bluff, AR 71603-6365

Phone

(870) 534-4188

Fax

(870) 534-7964

NPI assigned

Jan 6, 2010

Last updated

Oct 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Renee Bogy

Title

Office Manager

Phone

(870) 534-4188

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1255661732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 W 40TH AVE STE 403",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036365",
            "telephone_number": "870-534-4188",
            "fax_number": "870-534-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 W 40TH AVE STE 403",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036365",
            "telephone_number": "870-534-4188",
            "fax_number": "870-534-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE A FORESTIERE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "BOGY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-534-4188"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AR",
            "license": "C4813",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103036001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leeforestiere@jrmc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1609 W 40th Ave Ste 403",
            "city": "Pine Bluff",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716036365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Larisa Kachowski, MD (Larisa Kachowski Family Medicine, LLC)
• Aerielle Lawrence, PLMSW
• Lynette Lawrence
• Heather N Leblanc, MD
• India Ledbetter
• Florence Lee
• Monique Lee
• Amanda Christine Lem, APRN
• Stacy Leonard, MSPT
• Westy Dawn Leslie, PHARMD

• Medical Specialty Clinic/Center in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Medical Specialty Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.