Individual provider Active NPI

Christopher Thomas Fortson, M.D.

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1770842148
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-9194 Issued in AR
Practice address
1301 S E St
Fort Smith, AR 72901-4716
Phone
(479) 785-2431
Fax
(479) 494-7787
NPI assigned
May 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-9194 AR Primary

Addresses

Primary practice location

1301 S E St
Fort Smith, AR 72901-4716

Mailing address

612 S 12TH St
Fort Smith, AR 72901-4702
Phone (479) 785-2431

Other identifiers 2

IdentifierTypeStateIssuer
200492590AMedicaidOK
209362001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20150710002329 AR Practitioner - Family Practice 6305158825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 S E St
Fort Smith, AR 72901-3892
Phone (479) 785-2431

3505 S 79TH St
Fort Smith, AR 72903-6250
Phone (479) 709-8686

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-9194ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 1, 2016 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 1, 2016 Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

3505 S 79th St
Fort Smith, AR 72903
Phone (479) 709-6729

Interoperability endpoints

  • Direct secure messaging: cfortson327780@directb.mercy.net
  • Direct secure messaging: cfortson337437@directc.mercy.net

Organizations & group practices 4

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1770842148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S 12TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014702",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S E ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014716",
            "telephone_number": "479-785-2431",
            "fax_number": "479-494-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-9194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200492590A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209362001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.