James Everett Fortune, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

06635 Issued in MS

Practice address

7580 Clarington CV
Southaven, MS 38671-5657

Phone

(662) 349-1940

Fax

(662) 349-3212

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1861538951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380880847",
            "telephone_number": "901-821-0338",
            "fax_number": "901-507-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715657",
            "telephone_number": "662-349-1940",
            "fax_number": "662-349-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "JAMES",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD0000007792",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "06635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017199",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Folsom, PMHNP
• Kristin Schick Fonseca, O.D.
• Christy Fontenot, L.C.S.W.
• Nicole Marie Fontenot, DO
• Daniel B Fore, M.D.
• Foundation Internal Medicine, P.C.
• Denise F Fowler, LCSW
• Levi Fowler, DPT
• Mary Ashton Fowler, P-LPC
• Mary Fox

• Surgery Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.