Individual provider Active NPI

Mark Routon Fortson, M.D.

  • Gastroenterology Physician
  • Columbus, GA
National Provider Identifier
1457452591
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
024937 Issued in GA
Practice address
2200 Hamilton Rd Ste B
Columbus, GA 31904-8856
Phone
(706) 655-8800
Fax
(706) 940-9767
NPI assigned
Sep 25, 2006
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 24937 GA
Gastroenterology Physician 207RG0100X 024937 GA Primary

Addresses

Primary practice location

2200 Hamilton Rd Ste B
Columbus, GA 31904-8856

Mailing address

2200 Hamilton Rd Ste B
Columbus, GA 31904-8856
Phone (706) 655-8800

Other identifiers 2

IdentifierTypeStateIssuer
000274612MedicaidGA
10BDHLTOtherGAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20070614000539 GA Practitioner - Gastroenterology 4789782756 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024937GAMDGastroenterology Physician
24937GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Physician Practices LLC Current Accepting new patients
St Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
Southeastern Anesthesia Group LLC CurrentSince Oct 29, 2023 Accepting new patients
Southeastern Gastroenterology Associates, PC Gastroenterology CurrentSince Oct 1, 2022 Accepting new patients
St. Francis Physician Practices LLC Gastroenterology CurrentSince Jan 1, 2016 Accepting new patients
Southeastern Endoscopy Center LLC CurrentSince Dec 28, 2022 Accepting new patients

Locations

1905 7th Ave
Ste C
Columbus, GA 31901
Phone (703) 323-8954

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2200 Hamilton Rd
Ste A
Columbus, GA 31904
Phone (706) 221-6116

2200 Hamilton Rd
Ste B
Columbus, GA 31904
Phone (706) 221-6116

2300 Manchester Expy
Ste A201
Columbus, GA 31904
Phone (706) 243-4550

610 19th St
Columbus, GA 31901
Phone (706) 322-7884

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHDHCD
  • Direct secure messaging: mark.fortson@sfhga.gadirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1457452591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 HAMILTON RD STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048856",
            "telephone_number": "706-655-8800",
            "fax_number": "706-940-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HAMILTON RD STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048856",
            "telephone_number": "706-655-8800",
            "fax_number": "706-940-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTSON",
        "first_name": "MARK",
        "middle_name": "ROUTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "24937",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "024937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000274612",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "10BDHLT",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.