Individual provider Active NPI

Mary Lee Forte, DC

  • Chiropractor
  • Richfield, MN
National Provider Identifier
1790882868
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2535 Issued in MN
Practice address
6642 Penn Ave S
Richfield, MN 55423-2026
Phone
(612) 670-5790
Fax
(612) 861-2752
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2535 MN Primary

Addresses

Primary practice location

6642 Penn Ave S
Richfield, MN 55423-2026

Mailing address

6642 Penn Ave S
Richfield, MN 55423-2026
Phone (612) 670-5790

Other identifiers 1

IdentifierTypeStateIssuer
69D52FOOtherMNBCBS INDIVIDUAL PROVIDER

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forte Chiropractic Clinic PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790882868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6642 PENN AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232026",
            "telephone_number": "612-670-5790",
            "fax_number": "612-861-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6642 PENN AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232026",
            "telephone_number": "612-670-5790",
            "fax_number": "612-861-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTE",
        "first_name": "MARY",
        "middle_name": "LEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PROVIDER",
            "identifier": "69D52FO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.