Jennifer L Fortune, REGISTERED NURSE

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

565897 Issued in NY

Practice address

221 Hamilton St
Ogdensburg, NY 13669-1707

Phone

(315) 541-3042

NPI assigned

May 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennifer L Barr Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• United Helpers Care Inc

  • Medical Physician Assistant
  • Ogdensburg, NY
  • NPI 1740167535
  NPD (past)
• United Helpers Care Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ogdensburg, NY
  • NPI 1932938479
  NPD (past)

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1467026088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 HAMILTON ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691707",
            "telephone_number": "315-748-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HAMILTON ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691707",
            "telephone_number": "315-541-3042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 NY-310",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "13617",
            "country_code": "US",
            "telephone_number": "315-386-0264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "565897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THIRD PARTY",
            "identifier": "1578559159",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578559159",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "221Hamiltonst",
            "affiliation": "N",
            "address_1": "221 Hamilton St",
            "city": "Ogdensburg",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136691707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BARR",
            "middle_name": "L",
            "credential": "REGISTERED NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychiatric/Mental Health Registered Nurse in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.