Active NPI
Justin Anthony Fortier, D.C.
- Sports Physician Chiropractor
- Dallas, TX
National Provider Identifier
1376860270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 11395
- Practice address
- 6350 LBJ Fwy
Suite 166
Dallas, TX 75240-6403 - Phone
- (972) 742-7912
- NPI assigned
- May 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 11395 | TX | Primary |
Addresses
Primary practice location
6350 LBJ Fwy
Suite 166
Dallas, TX 75240-6403
Mailing address
7001 W Parker Rd
Apartment 534
Plano, TX 75093-8614
Phone (972) 742-7912
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11395 | TX | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272672000000",
"number": "1376860270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001 W PARKER RD",
"address_2": "APARTMENT 534",
"city": "PLANO",
"state": "TX",
"postal_code": "750938614",
"telephone_number": "972-742-7912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6350 LBJ FWY",
"address_2": "SUITE 166",
"city": "DALLAS",
"state": "TX",
"postal_code": "752406403",
"telephone_number": "972-742-7912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIER",
"first_name": "JUSTIN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-01",
"last_updated": "2010-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "TX",
"license": "11395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.