Active NPI
John David Fornara, O.D.
- Optometrist
- Cottonwood, AZ
National Provider Identifier
1336231653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 519
- Practice address
- 199 S Candy LN
Suite 2a
Cottonwood, AZ 86326-4183 - Phone
- (928) 634-2883
- Fax
- (928) 634-0110
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 519 | AZ | Primary |
Addresses
Primary practice location
199 S Candy LN
Suite 2a
Cottonwood, AZ 86326-4183
Mailing address
199 S Candy LN
Suite 2a
Cottonwood, AZ 86326-4183
Phone (928) 634-2883
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 |
|---|---|---|---|
| 519 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257811200000",
"number": "1336231653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 S CANDY LN",
"address_2": "SUITE 2A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264183",
"telephone_number": "928-634-2883",
"fax_number": "928-634-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 S CANDY LN",
"address_2": "SUITE 2A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264183",
"telephone_number": "928-634-2883",
"fax_number": "928-634-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNARA",
"first_name": "JOHN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2009-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AZ
- Kathy Lynn Fisher, O.M.D.,ACUPUNCTURIST
- Timothy J Fitch, PA-C
- Forefront Dermatology SC (Arizona Dermatology Group, a Forefront Dermatology Practice)
- Fornara Eye Center P.C.
- Jason Wesley Fornara, O.D.
- Irene Lynette Forrest, ARNP-C
- Founders Healthcare, LLC (Preferred Homecare)
- Dylan Frauhiger, DPT
- Fresenius Medical Care Cottonwood, LLC (Fresenius Kidney Care Cottonwood)
- Ken Froessel, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.