Jean M Fortgang, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN113594 NP Issued in GA

Practice address

3720 Davinci CT
Norcross, GA 30092-7627

Phone

(770) 582-3838

NPI assigned

Jan 10, 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609926187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 MCINTOSH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409680",
            "telephone_number": "770-582-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 DAVINCI CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300927627",
            "telephone_number": "770-582-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTGANG",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN113594   NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Ciandra Ford
• Shakirah Forde, LCSW
• Angelica Maria Forero, NP
• Nino Renzo Renzo Fornasini, MD
• Rakeisha Nichole Forte, NP-C
• Heather Nicole Forward, LCSW
• Deshun Foster, BCBA
• Asiah Foulks
• Four Corners Primary Care Centers Inc (Four Corners @ VPH)
• Four Corners Primary Care Centers, Inc.

• Family Nurse Practitioner in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Nurse Practitioner in Georgia

• 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.