Lydia Jane Fortner, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

51213 Issued in CA

Practice address

1649 Van Ness Ave
Fresno, CA 93721-1128

Phone

(559) 777-6722

NPI assigned

Jan 28, 2022

Last updated

Jan 28, 2022By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17371/brand/1/csg/1/fhir/r4

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.

• Sequoia Pace, LLC.

  • PACE Provider Organization
  • Fresno, CA
  • NPI 1063988384
  NPD

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1336892447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6358 N BENEDICT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937111605",
            "telephone_number": "559-906-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211128",
            "telephone_number": "559-777-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "LYDIA",
        "middle_name": "JANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Rae Forsyth, AMFT 128339
• James Clark Forsythe, MD
• Victoria Forsythe
• Fort Miller Middle School
• Dana Suzanne Fortier, LCSW
• Shyanne Fortunati-Ingram
• Forward BMH, Inc (Forward Family Services)
• Valerie Elizabeth Forward, PSYCHOLOGIST
• Megan Foss, LVN
• Scott Fosse, D.D.S.

• Physical Therapy Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.