Active NPI
Jessica Fortman, PA-C
- Physician Assistant
- West Chester, OH
National Provider Identifier
1841625324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.003826RX
- Practice address
- 9075 Centre Pointe Dr Ste 200
West Chester, OH 45069 - Phone
- (513) 221-1100
- Fax
- (513) 569-5312
- NPI assigned
- Sep 4, 2013
- Last updated
- May 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.003826RX | OH | Primary |
| Surgical Physician Assistant | 363AS0400X | 50.003826RX | OH |
Addresses
Primary practice location
9075 Centre Pointe Dr Ste 200
West Chester, OH 45069
Mailing address
PO Box 643398
Cincinnati, OH 45264-3398
Phone (513) 221-1100
Other practice location 1
3825 Edwards Rd Ste 300
Cincinnati, OH 45209-1288
Phone (513) 221-1100
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
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Orthosports Associates LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Orthopaedic Surgery Physician
- Birmingham, AL
- NPI 1700519600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1841625324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 643398",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452643398",
"telephone_number": "513-221-1100",
"fax_number": "513-569-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9075 CENTRE POINTE DR STE 200",
"city": "WEST CHESTER",
"state": "OH",
"postal_code": "45069",
"telephone_number": "513-221-1100",
"fax_number": "513-569-5312"
}
],
"practiceLocations": [
{
"address_1": "3825 Edwards Rd Ste 300",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452091288",
"country_code": "US",
"telephone_number": "513-221-1100",
"fax_number": "513-684-4501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTMAN",
"first_name": "JESSICA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-04",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.003826RX",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "OH",
"license": "50.003826RX",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.