Amy J Fort, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9216870 Issued in FL

Practice address

1426 Longoak Dr S
Lakeland, FL 33811-2115

Phone

(863) 640-7013

NPI assigned

May 4, 2006

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amyfort@moc.allscriptsdirect.net
• Direct secure messaging: ms_afort3@landmarkhealth-direct.org

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.

• Good Shepherd Hospice, Inc.

  dba Good Shepherd Hospice

  • Community Based Hospice Care Agency
  • Lakeland, FL
  • NPI 1235283151
  Medicare reassignment NPD
• Good Shepherd Hospice, Inc.

  dba Chapters Health Hospice

  • Community Based Hospice Care Agency
  • Marathon, FL
  • NPI 1720691017
  NPD
• Ocala Health Primary Care LLC

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1720398456
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1326096264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 LONGOAK DR S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338112115",
            "telephone_number": "863-640-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 LONGOAK DR S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338112115",
            "telephone_number": "863-640-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9216870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC8324",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074820-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Magdalene Ford, RBT
• Tracie M Ford, LCSW
• Matthew Joseph Forestiere, M.D.
• Kristen Moore Forgue, MS CCCSLP
• Damaris Yamilet Fornaris Garcell
• Dominick Richard Fortunato, BEHAVIOR TECHNICIAN
• Carlos Enrique Fossi, M,D.
• Kiasia Lashae Foster
• Latoyta Foster
• Syctrilos Yvette Foster, M.A.

• Family Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.