Active NPI
Elizabeth Marie Fortener, P.T.
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1316988827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11608
- Practice address
- 8470 Falls of Neuse Rd
Ste 106
Raleigh, NC 27615-3550 - Phone
- (919) 803-0738
- NPI assigned
- Jun 8, 2006
- Last updated
- Aug 22, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1997 | NV | |
| Physical Therapist | 225100000X | 11608 | NC | Primary |
Addresses
Primary practice location
8470 Falls of Neuse Rd
Ste 106
Raleigh, NC 27615-3550
Mailing address
8470 Falls of Neuse Rd
Ste 106
Raleigh, NC 27615-3550
Phone (919) 803-0738
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100509062 | Medicaid | NV |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1997 | NV | MD | Specialist |
| 11608 | NC | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chynoweth Hill and Leavitt LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Kelly Hawkins Physical Therapy Works
- Multi-Specialty Clinic/Center
- Las Vegas, NV
- NPI 1164415279
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1316988827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8470 FALLS OF NEUSE RD",
"address_2": "STE 106",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153550",
"telephone_number": "919-803-0738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8470 FALLS OF NEUSE RD",
"address_2": "STE 106",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153550",
"telephone_number": "919-803-0738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTENER",
"first_name": "ELIZABETH",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NV",
"license": "1997",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100509062",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.