Antonia Forster, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

667 Issued in OR

Practice address

5440 SW Westgate Dr
Suite 175
Portland, OR 97221-2420

Phone

(971) 998-7489

Fax

(503) 297-5744

NPI assigned

Mar 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Neuropsychology LLC

  • Clinical Child & Adolescent Psychologist
  • Portland, OR
  • NPI 1851054266
  Medicare reassignment NPD
• Robert W McLellarn, PHD

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1174813539
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568596591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "SUITE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "971-998-7489",
            "fax_number": "503-297-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "SUITE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "971-998-7489",
            "fax_number": "503-297-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSTER",
        "first_name": "ANTONIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beck Forsland, DC
• Anna Forsline
• Todd D Forsman, MSW
• Cora Victoria Jacobine Forsten, N.D., L.AC
• Andrew Forster, DDS
• Aviel Forster
• Cheryl Forster, PSY.D.
• Sara Marie Forster, PSYD
• Zachary Edward Forsyth
• Daniel Forsythe

• Clinical Neuropsychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Neuropsychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.