Mary Pat Forkin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01035037 Issued in IN

Practice address

15229 Westfield Blvd
Carmel, IN 46032-8000

Phone

(317) 867-1236

Fax

(317) 896-1299

NPI assigned

Oct 26, 2006

Last updated

Oct 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.pat.forkin@58699484823556.direct.elationemr.com

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.

• American Health Network of Indiana, LLC

  • Family Medicine Physician
  • Mulberry, IN
  • NPI 1033220017
  NPD (past)
• American Health Network of Indiana, LLC

  • Family Medicine Physician
  • Westfield, IN
  • NPI 1467488668
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1811072705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15229 WESTFIELD BLVD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328000",
            "telephone_number": "317-867-1236",
            "fax_number": "317-896-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15229 WESTFIELD BLVD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328000",
            "telephone_number": "317-867-1236",
            "fax_number": "317-896-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORKIN",
        "first_name": "MARY",
        "middle_name": "PAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01035037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200009030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Abigail Foor
• Sarah Cady Ford, MA, CCC-SLP
• Stephanie Michelle Ford, OT
• Forefront Dermatology, S.C.
• Forest Aura Wellness, Inc.
• James Franklin Forrester Jr.
• Elizabeth Forsyth-Whalen, PT
• Fort Wayne Retina, P.C.
• Fortitude Wound Care LLC
• Natalia Fortunato

• Family Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.