Individual provider Active NPI

Tessa R Forbeck, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Cumberland, MD
National Provider Identifier
1790021491
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
19320 Issued in MD
Practice address
12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone
(240) 964-2100
NPI assigned
Dec 27, 2012
Last updated
Dec 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 19320 MD Primary

Addresses

Primary practice location

12500 Willowbrook Rd
Cumberland, MD 21502-6393

Mailing address

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19320MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1790021491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "240-964-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "240-964-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBECK",
        "first_name": "TESSA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "19320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.