Active NPI
Caleb Fortenberry, DC
- Chiropractor
- Gulfport, MS
National Provider Identifier
1356957732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1314
- Practice address
- 2045 E Pass Rd Ste B
Gulfport, MS 39507-3761 - Phone
- (228) 896-7574
- Fax
- (228) 896-7579
- NPI assigned
- Sep 21, 2020
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1314 | MS | Primary |
Addresses
Primary practice location
2045 E Pass Rd Ste B
Gulfport, MS 39507-3761
Mailing address
2045 E Pass Rd Ste B
Gulfport, MS 39507-3761
Phone (228) 896-7574
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600646400000",
"number": "1356957732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2045 E PASS RD STE B",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073761",
"telephone_number": "228-896-7574",
"fax_number": "228-896-7574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 E PASS RD STE B",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073761",
"telephone_number": "228-896-7574",
"fax_number": "228-896-7579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTENBERRY",
"first_name": "CALEB",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-21",
"last_updated": "2020-09-21",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MS",
"license": "1314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.