Maria Anne Fortin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03271 Issued in NC

Practice address

1439 E Cone Blvd
Greensboro, NC 27405-4533

Phone

(833) 904-2273

NPI assigned

Jan 9, 2012

Last updated

Mar 21, 2022By 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

Other names 1

• Maria Anne Lindholm Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: maria.fortin.1@27775.direct.athenahealth.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.

• Cityblock Medical Practice, P.a.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1588296784

  NC

  Medicare reassignment
• County of Stokes

  dba Stokes Family Health Center

  • Public Health or Welfare Agency
  • Danbury, NC
  • NPI 1316914534
  NPD (past)
• Stokes Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Danbury, NC
  • NPI 1083940795
  NPD (past)

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1821368895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 E CONE BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054533",
            "telephone_number": "833-904-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 E CONE BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054533",
            "telephone_number": "833-904-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "MARIA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2022-03-21",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101857",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "LINDHOLM",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Forsyth Memorial Hospital, Inc. (Novant Health Triad Endocrine)
• Kymberly Carol Forsyth, M.D.
• Sarah W Forsythe
• Allison Forti
• Andrea Yvette Fortier
• Tony Joe Fortin, LCMHCS, LCAS, CCS
• Michael Cameron Fortner, MD
• Fortune Premier Services LLC
• Alexander F Fortune, MD
• Foster Am Transportation Services LLC

• Physician Assistant in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.