Organization Active NPI

Fortis Med Incorporated

  • Geriatric Medicine (Family Medicine) Physician
  • Fort Worth, TX
National Provider Identifier
1790527174
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
FORTIS MED INCORPORATED
Doing business as
FORTIS PHYSICIANS
Practice address
12417 Bella Vino Dr
Fort Worth, TX 76126-4929
Phone
(817) 239-1071
Fax
(817) 782-9468
NPI assigned
Jun 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Dr. Savita Kurup, MDNPI 1568457968
Title
President
Phone
(817) 239-1071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

12417 Bella Vino Dr
Fort Worth, TX 76126-4929

Mailing address

12417 Bella Vino Dr
Fort Worth, TX 76126-4929
Phone (817) 239-1071

Other names 1

  • FORTIS PHYSICIANS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1790527174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 BELLA VINO DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761264929",
            "telephone_number": "817-239-1071",
            "fax_number": "817-782-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 BELLA VINO DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761264929",
            "telephone_number": "817-239-1071",
            "fax_number": "817-782-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTIS MED INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "KURUP",
        "authorized_official_first_name": "SAVITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-239-1071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORTIS PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.