Individual provider Active NPI

Forest Rathfon

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1639813298
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12898 Issued in NC
Practice address
2300 Ramsey St
Fayetteville, NC 28301-3856
Phone
(910) 488-2120
NPI assigned
Apr 20, 2022
Last updated
Jul 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
General Practice Dentistry 1223G0001X 12898 NC Primary

Addresses

Primary practice location

2300 Ramsey St
Fayetteville, NC 28301-3856

Mailing address

PO Box 305
Simpsonville, KY 40067-0305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12898NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1639813298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "SIMPSONVILLE",
            "state": "KY",
            "postal_code": "400670305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-488-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHFON",
        "first_name": "FOREST",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; 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.