Andrew Dodd Fortenberry, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10406 Issued in CO

Practice address

289 Ireland Ave
Fort Knox, KY 40121

Phone

(502) 624-9431

NPI assigned

Jun 17, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Baylor College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Orthopaedic Physical Therapy, PSCGroup PAC ID 7113946336, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Orthopaedic Physical Therapy, PSC

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1912050618

  KY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1497982383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "40121",
            "telephone_number": "502-624-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "ANDREW",
        "middle_name": "DODD",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Laryssa Epperson, PA-C
• Robert Gale Evans, LCSW
• Exceptional Eye Care, LLC
• Mitchell Timothy Fackler, DDS
• Janis Hinds Flynn, LCSW
• Benjamin Tully Foster, PT, DPT
• Marcus Franklin, RPH
• Cynthia Spears French, FNP
• Willie Parker French, PHYSICIAN ASSISTANT
• Bruce Fried, M.D

• All providers in Fort Knox, KY
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.