Active NPI
Sidney Ray Fortney, MD
- Endocrinology, Diabetes & Metabolism Physician
- Oak Island, NC
National Provider Identifier
1417947714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 13798
- Practice address
- 8715 E Oak Island Dr
Oak Island, NC 28465-8367 - Phone
- (910) 278-3316
- Fax
- (910) 278-1415
- NPI assigned
- Oct 27, 2005
- 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 |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 13798 | NC | Primary |
Addresses
Primary practice location
8715 E Oak Island Dr
Oak Island, NC 28465-8367
Mailing address
8715 E Oak Island Dr
Oak Island, NC 28465-8367
Phone (910) 278-3316
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8933170 | Medicaid | NC | |
| P00399761 | Other | NC | RR MEDICARE |
| 33170 | Other | NC | BCBS IND PROV # |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13798 | NC | MD | Occupational Therapist |
Interoperability endpoints
- sidney.fortney.1@20427.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1417947714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8715 E OAK ISLAND DR",
"city": "OAK ISLAND",
"state": "NC",
"postal_code": "284658367",
"telephone_number": "910-278-3316",
"fax_number": "910-278-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8715 E OAK ISLAND DR",
"city": "OAK ISLAND",
"state": "NC",
"postal_code": "284658367",
"telephone_number": "910-278-3316",
"fax_number": "910-278-1415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTNEY",
"first_name": "SIDNEY",
"middle_name": "RAY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-27",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "NC",
"license": "13798",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8933170",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00399761",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND PROV #",
"identifier": "33170",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Island, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.