Jay Nathan Fortner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

TX18583 Issued in TX

Practice address

8209 Genoa Avenue
Suite 100
Lubbock, TX 79424

Phone

(806) 791-1481

Fax

(806) 791-1480

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1568564359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8209 GENOA AVENUE",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-791-1481",
            "fax_number": "806-791-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8209 GENOA AVENUE",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-791-1481",
            "fax_number": "806-791-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "JAY",
        "middle_name": "NATHAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "TX18583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foresight Eye Care PLLC
• Gianluigi Fornari, M.D.
• Jennifer Lynn Fornari, APRN, FNP-C
• Joe Forsman, D.D.S., M.S.
• April Dawn Fortner, L.P.C.
• Misty Kay Fortner, PA-C
• Robert Brown Fortney, NCC, LPC
• Fortress Home Care, LLC
• Cassie Foster, CCC-SLP
• Katrina Foster, NP-C

• Dentist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.