Clara Sue Forrester, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

531980 Issued in TX

Practice address

4405 River Oaks Blvd
Fort Worth, TX 76114-2326

Phone

(817) 624-1770

Fax

(817) 625-1287

NPI assigned

Jan 9, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cook Children'S Medical Center

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1942509963
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1649258633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99371",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990371",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 RIVER OAKS BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761142326",
            "telephone_number": "817-624-1770",
            "fax_number": "817-625-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "CLARA",
        "middle_name": "SUE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "531980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN GROUP",
            "identifier": "137345810",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062616004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "062616005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN GROUP",
            "identifier": "00U87Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "140442852",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forest Park Mecial Center at Fort Worth, LLC
• Mark David Forester, BS CCSH
• Shaun Michael Foret
• Clara Formusoh, NP
• Kandace Forooshani-Ficklin
• Alyssa Nicole Forsyth
• Fort Austin Limited Partnership
• Fort Healthcare LLC
• Fort Healthcare LLC
• Fort Physicians & Professionals PLLC

• Pediatric Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.