Geoffrey Mark Fortner, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

01056568A Issued in IN

Practice address

7165 Clearvista Way
Indianapolis, IN 46256

Phone

(317) 621-5100

NPI assigned

Oct 6, 2006

Sex

Male

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gfortner30684@ecommunitydirect.com

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.

• Aspire Indiana Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1124016050
  Medicare reassignment NPD
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Medicare reassignment NPD
• Community Howard Regional Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kokomo, IN
  • NPI 1881947133
  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Fairbanks Hospital, Inc.

  • Psychiatric Hospital
  • Indianapolis, IN
  • NPI 1619072493
  Medicare reassignment NPD
• Jane Pauley Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1730488818
  Medicare reassignment NPD
• Community Health Network, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1265477632
  NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Community Health Network, Inc.

  • Psychiatric Hospital Unit
  • Indianapolis, IN
  • NPI 1679545966
  NPD (past)
• Meridian Health Group

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Carmel, IN
  • NPI 1255409413
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1669569059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 CLEARVISTA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46256",
            "telephone_number": "317-621-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "697 Pro-Med Ln",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325323",
            "country_code": "US",
            "telephone_number": "317-574-0500",
            "fax_number": "317-674-0059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "697 Pro-Med Ln",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325323",
            "country_code": "US",
            "telephone_number": "317-574-0500",
            "fax_number": "317-674-0059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "GEOFFREY",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01056568A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200505110",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gfortner30684@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Fortino
• Matthew Fortino
• Debbie Fortman
• Stephanie Ann Fortman, PMHNP
• Sarah Nicole Fortna, MD
• Leanne M Fortner, M.D.
• Lawrence N. Fortress, D.D.S
• Jessica H. Fortunak, NP
• Joseph Domenic Fortunato, D.C.
• Amy Lynn Fortune, RN, BSN

• Neurology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.