Andrea Kristina Foretnberry

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

195467NC Issued in NC

Practice address

1895 E Dixon Blvd
Shelby, NC 28152-6901

Phone

(704) 466-3970

Fax

(704) 600-6011

NPI assigned

Feb 18, 2019

Last updated

Feb 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1629534391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 EAST DIXON BLVD SHELBY NC 28152",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28152",
            "telephone_number": "704-466-3970",
            "fax_number": "704-600-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526901",
            "telephone_number": "704-466-3970",
            "fax_number": "704-600-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORETNBERRY",
        "first_name": "ANDREA",
        "middle_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "195467NC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Shelby, NC
• Providers in Shelby, NC by specialty
• Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.