Anthony Lee Fortin, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

26214 Issued in MS

Practice address

2500 N State St
Radiology
Jackson, MS 39216-4500

Phone

(601) 984-2500

NPI assigned

Mar 27, 2017

Last updated

Aug 7, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Field Memorial Community HospitalGroup PAC ID 0547248544, shared by 7 NPIs, 41 clinicians

Franklin County Memorial HospitalGroup PAC ID 2466355243, 37 clinicians

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Comprehensive Radiology Services PLLCGroup PAC ID 1759364946, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• Wayne General Hospital Hospital, Waynesboro, MS, CCN 250077
• Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094
• Highland Community Hospital Hospital, Picayune, MS, CCN 250117
• Covington County Hospital Cah Hospital, Collins, MS, CCN 251325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afortin54637@ummc.direct-ci.com

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.

• Comprehensive Radiology Services, PLLC

  • Diagnostic Radiology Physician
  • Hattiesburg, MS
  • NPI 1992731590
  Medicare reassignment Care Compare group NPD
• Franklin County Memorial Hospital

  • Critical Access Hospital
  • Meadville, MS
  • NPI 1669705612
  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Field Memorial Community Hospital

  dba Field Health System

  • Critical Access Hospital
  • Centreville, MS
  • NPI 1770574048
  Medicare reassignment NPD
• Field Memorial Community Hospital

  dba Catchings Clinic

  • Rural Health Clinic/Center
  • Woodville, MS
  • NPI 1881648376
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Field Memorial Community Hospital

  dba Field Health System

  • Medicare Defined Swing Bed Hospital Unit
  • Centreville, MS
  • NPI 1447217526
  NPD
• Field Memorial Community Hospital

  dba Field Health System

  • Critical Access Hospital
  • Centreville, MS
  • NPI 1871633347
  NPD
• Franklin County Memorial Hospital

  dba Family Medical Group of Bude

  • Rural Health Clinic/Center
  • Bude, MS
  • NPI 1457657363
  NPD
• Franklin County Memorial Hospital

  • General Acute Care Hospital
  • Meadville, MS
  • NPI 1639121445
  NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covington County Hospital

  • Critical Access Hospital
  • Collins, MS
  • NPI 1215965249
  Care Compare affiliation
• Forrest County General Hospital

  dba Highland Community Hospital

  • General Acute Care Hospital
  • Picayune, MS
  • NPI 1053350462
  Care Compare affiliation
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• Wayne General Hospital

  • General Acute Care Hospital
  • Waynesboro, MS
  • NPI 1679559983
  Care Compare affiliation
• Wesley Health System LLC

  dba Merit Health Wesley

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  Care Compare affiliation

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1437680899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "RADIOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "RADIOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Professional Pkwy Ste 126",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394022647",
            "country_code": "US",
            "telephone_number": "601-450-0521",
            "fax_number": "601-450-0518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-264-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "ANTHONY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "T-3337",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "26214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian R Fortenberry, FNP
• Deborah Fortenberry, L.H.I.S
• Faith Fortenberry, DO
• Jackie Fortenberry, CRNA
• Susan Cope Fortenberry, D.M.D.
• Audrey Lee Fortin, DMD
• John Dudley Foss, M.D.
• Charity Foster
• Danielle Christine Foster, RN, MD
• Kristen Dawn Foster, FNP-C, AGACNP-BC

• Diagnostic Radiology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.