Individual provider Active NPI

Emily Kristin Forrest, MD

  • Developmental - Behavioral Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1508060765
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME112108 Issued in FL
Practice address
615 E Princeton St
Suite 300
Orlando, FL 32803-1456
Phone
(407) 898-6005
Fax
(407) 898-7722
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 235318 NY
Developmental - Behavioral Pediatrics Physician 2080P0006X ME112108 FL Primary

Addresses

Primary practice location

615 E Princeton St
Suite 300
Orlando, FL 32803-1456

Mailing address

615 E Princeton St
Suite 300
Orlando, FL 32803-1456
Phone (407) 898-6005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120413000668 FL Practitioner - Pediatric Medicine 1850332396 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235318NYMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Apr 1, 2012 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 1, 2012 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 300
Orlando, FL 32803
Phone (407) 228-4774

615 E Princeton St
Ste 104
Orlando, FL 32803
Phone (407) 303-1575

Interoperability endpoints

  • Direct secure messaging: eforrest73617@adventhealth.direct-ci.com

Organizations & group practices 2

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1508060765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST",
            "address_2": "SUITE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031456",
            "telephone_number": "407-898-6005",
            "fax_number": "407-898-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST",
            "address_2": "SUITE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031456",
            "telephone_number": "407-898-6005",
            "fax_number": "407-898-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "EMILY",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "235318",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME112108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.