Individual provider Active NPI

James Albert Fortune, MD

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1558322818
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301043464 Issued in MI
Practice address
20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775
Phone
(596) 779-8700
Fax
(586) 498-1425
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301043464 MI Primary

Addresses

Primary practice location

20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775

Mailing address

20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775
Phone (596) 779-8700

Other identifiers 1

IdentifierTypeStateIssuer
2121462MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20091217000437 MI Practitioner - Family Practice 4486794799 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

15055 22 Mile Rd
Ste 3
Shelby Township, MI 48315
Phone (586) 566-7100

20225 E 9 Mile Rd
Ste A
St Clr Shores, MI 48080
Phone (586) 772-1090

20225 E 9 Mile Rd
St Clr Shores, MI 48080
Phone (586) 772-1090

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: jfortune1127053@direct.hfhs.org
  • Direct secure messaging: james.fortune.2@8209.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

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, 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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1558322818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "596-779-8700",
            "fax_number": "586-498-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "596-779-8700",
            "fax_number": "586-498-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "JAMES",
        "middle_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301043464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121462",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.