NPIMap

Jennifer E Forte, D.O.

Individual provider Active NPI Internal Medicine Physician · Pueblo, CO

NPI 1700224664 · NPPES record last updated Sep 1, 2016

Key facts

NPI
1700224664
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
4626 (CO)
Practice address
311 W 14TH St
Pueblo, CO 81003-2710
Phone
(719) 595-7585
Fax
(719) 595-7589
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 13

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Grand Junction, LLC (297 clinicians)
Lutheran Hospital Association of the San Luis Valley (146 clinicians)

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-2511

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital · Grand Junction, CO · CCN 060023
  • San Luis Valley Regional Medical Center Hospital · Alamosa, CO · CCN 060008

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160721001029 CO Practitioner - Internal Medicine 0547402331 Reassigns benefits to 4 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4626COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Current
since Nov 1, 2020		 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Current
since Feb 4, 2019		 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Current
since Feb 4, 2019		 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine Current
since Nov 1, 2020		 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Internal Medicine Current Accepting new patients

Locations

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X DR.0053938 CO
Internal Medicine Physician 207R00000X 4626 CO Yes

Addresses

Primary practice location

311 W 14TH St
Pueblo, CO 81003-2710

Mailing address

PO Box 560825
Denver, CO 80256-0825
Phone (719) 595-7580

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 1, 2016.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1700224664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7580",
            "fax_number": "719-545-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 14TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032710",
            "telephone_number": "719-595-7585",
            "fax_number": "719-595-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTE",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CO",
            "license": "DR.0053938",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "4626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

All providers in Pueblo, CO · Internal Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.