Individual provider Active NPI

Forrest R. E. Hartford, D.C.

  • Chiropractor
  • Gig Harbor, WA
National Provider Identifier
1609015247
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60066715 Issued in WA
Practice address
5125 Olympic Dr NW Ste 110
Gig Harbor, WA 98335-1712
Phone
(253) 853-4000
Fax
(253) 853-4001
NPI assigned
Feb 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6006715 WA
Chiropractor 111N00000X CH60066715 WA Primary

Addresses

Primary practice location

5125 Olympic Dr NW Ste 110
Gig Harbor, WA 98335-1712

Mailing address

5125 Olympic Dr NW Ste 110
Gig Harbor, WA 98335-1712
Phone (253) 853-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221000014 WA Practitioner - Chiropractic 3173711942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro Sport and Spine PLLCGroup PAC ID 1658656384, 15 clinicians

Practice addresses (Care Compare)

5160 Borgen Blvd
Suite 101
Gig Harbor, WA 98332-8809
Phone (253) 853-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60066715WAMDChiropractor
CH6006715WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Sport and Spine PLLC CurrentSince Feb 11, 2017 Accepting new patients
Pro Sport Orthopedics, LLC PastSince Jul 1, 2019 Accepting new patients
Pro Sport Physical Therapy, LLC PastSince Jun 27, 2019 Accepting new patients

Locations

5160 Borgen Blvd
Ste 101
Gig Harbor, WA 98332
Phone (253) 853-4000

5125 Olympic Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 833-4000

Organizations & group practices 3

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1609015247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 OLYMPIC DR NW STE 110",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351712",
            "telephone_number": "253-853-4000",
            "fax_number": "253-853-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 OLYMPIC DR NW STE 110",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351712",
            "telephone_number": "253-853-4000",
            "fax_number": "253-853-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTFORD",
        "first_name": "FORREST",
        "middle_name": "R. E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH6006715",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60066715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.