Forge Health & Wellness LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

FORGE HEALTH & WELLNESS LLC

Practice address

2970 Ross Clark Cir Ste 2
Dothan, AL 36301-1107

Phone

(334) 790-4090

Fax

(334) 603-9532

NPI assigned

Jan 5, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dennis Wade Stewart, PA

Title

Owner/Director

Phone

(334) 790-4090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1427762384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CLARKSDALE CT",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051270",
            "telephone_number": "334-790-4090",
            "fax_number": "334-603-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 ROSS CLARK CIR STE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011107",
            "telephone_number": "334-790-4090",
            "fax_number": "334-603-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORGE HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "334-790-4090",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Dothan, AL
• Providers in Dothan, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.