Forrest Fasig, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

11750 Issued in NV

Practice address

480 Galletti Way
Sparks, NV 89431-5564

Phone

(775) 688-2028

Fax

(775) 688-3308

NPI assigned

Jun 7, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1700224128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-2028",
            "fax_number": "775-688-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-2028",
            "fax_number": "775-688-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASIG",
        "first_name": "FORREST",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "11750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Sparks, NV
• Providers in Sparks, NV by specialty
• Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.