Individual provider Active NPI

Joanna Lynn Fortin, DPT

  • Physical Therapist
  • Palm Desert, CA
National Provider Identifier
1457894594
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 43210 Issued in CA
Practice address
41555 Cook St
Suite 100
Palm Desert, CA 92211-5184
Phone
(760) 837-0033
Fax
(760) 837-1013
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 43210 CA Primary

Addresses

Primary practice location

41555 Cook St
Suite 100
Palm Desert, CA 92211-5184

Mailing address

41555 Cook St
Suite 100
Palm Desert, CA 92211-5184
Phone (760) 837-0033

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 Philosophy

State licenses

LicenseStateTypeSpecialty
43210CAMDPharmacist
PT 43210CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Easy Speech Therapy Center PastSince Nov 23, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1457894594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41555 COOK ST",
            "address_2": "SUITE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115184",
            "telephone_number": "760-837-0033",
            "fax_number": "760-837-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41555 COOK ST",
            "address_2": "SUITE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115184",
            "telephone_number": "760-837-0033",
            "fax_number": "760-837-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 43210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.