Michael Scott Fortner, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C002946 Issued in AR

Practice address

1601 New Castle Rd
Forrest City, AR 72335-2218

Phone

(870) 261-0513

Fax

(901) 261-2542

NPI assigned

Aug 12, 2005

Last updated

Dec 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in TN, NC, AR3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  NC, Nurse Anesthetist, Certified Registered, TN

  Medicare reassignment Care Compare group NPD
• Southern Regional Anesthesiology Consultants PLLC

  • Anesthesiology Physician
  • Little Rock, AR
  • NPI 1902231673
  Medicare reassignment NPD
• East Memphis Anesthesia Services PLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1578592663
  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  AR, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia and Pain Consultants,P.C.

  • Anesthesiology Physician
  • Johnson City, TN
  • NPI 1750399127

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Medstream of Virginia, LLC

  • Anesthesiology Physician
  • Asheville, NC
  • NPI 1770839201

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Sevier Anesthesia Associates, P.C

  • Certified Registered Nurse Anesthetist
  • Sevierville, TN
  • NPI 1629068416

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Hospital of Surry County

  dba North Hospital of Surry County

  • General Acute Care Hospital
  • Mount Airy, NC
  • NPI 1366449282
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1871595512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771522",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381771522",
            "telephone_number": "901-249-7668",
            "fax_number": "901-261-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NEW CASTLE RD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352218",
            "telephone_number": "870-261-0513",
            "fax_number": "901-261-2542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Martin Luther King Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Helena",
            "state": "AR",
            "postal_code": "723428998",
            "country_code": "US",
            "telephone_number": "870-816-3780",
            "fax_number": "901-261-2542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002946",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R105201",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE - SOUTH REGION",
            "identifier": "1871595512",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE-PALMETTO GBA",
            "identifier": "P00820226",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE OF ARKANSAS",
            "identifier": "1871595512",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1871595512",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TENNESSEE",
            "identifier": "4245152",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196069001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUE CROSS BLUE SHIELD",
            "identifier": "1871595512",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BAPTIST HEALTH SERVICES GROUP, INC.",
            "identifier": "1871595512",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE - MEDICARE",
            "identifier": "1871595512",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forrest City Family Practice Clinic, PA
• Forrest City Home Medical Equipment, LLC
• Forrest City Home Medical Equipment, LLC
• Forrest City Physician Services, PLLC
• Forrest City School District
• Four Seasons Home Care LLC
• Frank R Schwartz MD PA
• James Francis Franks, MD
• Nellie Freeman
• Anna Frein, LMSW

• Certified Registered Nurse Anesthetist in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.