Richard Fortney, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1549 Issued in AZ

Practice address

2060 W 24TH St
Yuma, AZ 85364-6123

Phone

(928) 539-3082

Fax

(928) 539-5579

NPI assigned

Jul 19, 2006

Last updated

Feb 24, 2014By the provider in NPPES

Sex

Male

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Level 4 Medical Professional Corporation

  dba Foothills Walk-in Medical and Urgent Care

  • Basic Emergency Medical Technician
  • Yuma, AZ
  • NPI 1023041654
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1376563999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646123",
            "telephone_number": "928-539-3082",
            "fax_number": "928-539-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646123",
            "telephone_number": "928-539-3082",
            "fax_number": "928-539-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNEY",
        "first_name": "RICHARD",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1043324932",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1245344316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1063433720",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1962507376",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162355",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Foothills Walkin Medical
• Patrick Craig Ford, PHYSICIAN ASSISTANT
• Kendra Lashon Foreman, APRN
• Form Physical Therapy & Rehabilitation PLLC
• David Wayne Fornof Jr., PARAMEDIC
• Fortuna Medical Group
• Fortuna Medical Group Physical Therapy & Rehab
• Fortuna Medical Transportation LLC
• Anthony Javahr Foster, OTD, OTR/L
• Founders Healthcare, LLC (Preferred Homecare)

• Physician Assistant in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.