Fortis Healthcare, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

FORTIS HEALTHCARE, INC.

Practice address

8002 NE Highway 99
#114
Vancouver, WA 98665-8876

Phone

(503) 806-0855

NPI assigned

Feb 1, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Engelberto Peynado

Title

Chief Operations Officer

Phone

(503) 806-0855

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1629436027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 NE HIGHWAY 99",
            "address_2": "#114",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 NE HIGHWAY 99",
            "address_2": "#114",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658876",
            "telephone_number": "503-806-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTIS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "PEYNADO",
        "authorized_official_first_name": "ENGELBERTO",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "503-806-0855",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bradley Justin Fosnot

• Community Based Hospice Care Agency in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Community Based Hospice Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.