Tabitha R Fortner, CRANIAL PROSTHESIS

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

5710 Simmons St # A1
North Las Vegas, NV 89031-9900

Phone

(323) 921-5084

NPI assigned

Feb 3, 2025

Last updated

Feb 3, 2025By 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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1639983349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 HORSE POINTE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890841225",
            "telephone_number": "323-921-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 SIMMONS ST # A1",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890319900",
            "telephone_number": "323-921-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "TABITHA",
        "middle_name": "R",
        "credential": "CRANIAL PROSTHESIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Edward Foreman
• Rhiannon Nicole Foreman
• Harim H Forestall
• Keyonna Forestall
• Milagros Fors-Sanchez
• Kristopher Foss
• Teresa Marie Foss, APRN
• Destynee Foster
• Larhonda Donisha Foster
• Shawn Y Foster

• Prosthetic/Orthotic Supplier in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Prosthetic/Orthotic Supplier in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.