Dennis Leroy Fortner III, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9105894 Issued in FL

Practice address

298 S Yonge St
Ormond Beach, FL 32174-6264

Phone

(386) 479-2151

NPI assigned

Feb 11, 2011

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

Medicare fee-for-service enrollment

Enrolled in FL

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

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 and National Provider Directory roles.

• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  Medicare reassignment
• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  Medicare reassignment
• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  NPD
• Florida Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1609296011

  Physician Assistant

  NPD (past)
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  NPD (past)
• Kite Emergency Physicians LLC

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1295155547
  NPD (past)

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476576000000",
    "number": "1891092771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746264",
            "telephone_number": "386-479-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746264",
            "telephone_number": "386-479-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "DENNIS",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-11",
        "last_updated": "2016-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105894",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aurora Joy Ford, LMT
• Jessica M Ford, L.M.T
• Amanda Forister, MS
• Donald Joseph Fornace, DO FACC
• Brittany Forster, DPT
• Cailin Foster
• Four Winds Acupuncture
• Hannah Fowler
• Deborah Ann Fox, OTR
• Joseph M France, MD

• Medical Physician Assistant in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2016; 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.