Individual provider Active NPI

Jon Steven Forbes Jr., CF-SLP

  • Speech-Language Pathologist
  • Belfast, ME
National Provider Identifier
1255900148
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ST3507 Issued in ME
Practice address
118 Northport Ave
Belfast, ME 04915-6009
Phone
(207) 338-2500
NPI assigned
Jun 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X ST3507 ME Primary

Addresses

Primary practice location

118 Northport Ave
Belfast, ME 04915-6009

Mailing address

243 Nowell Rd
Bangor, ME 04401-3414
Phone (408) 368-0383

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

LicenseStateTypeSpecialty
ST3507MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1255900148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NOWELL RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013414",
            "telephone_number": "408-368-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTHPORT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156009",
            "telephone_number": "207-338-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "JON",
        "middle_name": "STEVEN",
        "name_suffix": "Jr.",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST3507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.