Denise Fortenberry Fortenberry-Gratias, ACNP-C

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

17284 Issued in CA

Practice address

520 Superior Ave,
Suite 350
Newport Beach, CA 92663

Phone

(949) 764-8062

Fax

(949) 764-5607

NPI assigned

May 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Denise Renee Fortenberry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1326330119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE,",
            "address_2": "SUITE 350",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-764-8062",
            "fax_number": "949-764-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE,",
            "address_2": "SUITE 350",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-764-8062",
            "fax_number": "949-764-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY-GRATIAS",
        "first_name": "DENISE",
        "middle_name": "FORTENBERRY",
        "name_prefix": "Mrs.",
        "credential": "ACNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "17284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "FORTENBERRY",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "ACNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.