Organization Active NPI

John Fornarotto PLLC

  • Ophthalmology Physician
  • Pocatello, ID
National Provider Identifier
1790838662
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JOHN FORNAROTTO PLLC
Practice address
246 N 18TH Ave
Pocatello, ID 83201-3356
Phone
(208) 234-4100
Fax
(208) 234-4192
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Authorized official

Name
Dr. John M Fornarotto, MD
Title
Owner
Phone
(208) 234-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

246 N 18TH Ave
Pocatello, ID 83201-3356

Mailing address

246 N 18TH Ave
Pocatello, ID 83201-3356
Phone (208) 234-4100

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1790838662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 N 18TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013356",
            "telephone_number": "208-234-4100",
            "fax_number": "208-234-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 N 18TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013356",
            "telephone_number": "208-234-4100",
            "fax_number": "208-234-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN FORNAROTTO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "FORNAROTTO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-234-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.