Lisa Marie McDonald Fortune, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT16461 Issued in FL

Practice address

3311 Beach Blvd
Jacksonville, FL 32207-3704

Phone

(904) 396-1462

Fax

(904) 396-1199

NPI assigned

Mar 10, 2016

Last updated

May 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• New Heights of Northeast Florida, Inc.

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
  • NPI 1649317942
  Medicare reassignment

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1942661525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6273 BROOKS CIR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117510",
            "telephone_number": "904-482-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073704",
            "telephone_number": "904-396-1462",
            "fax_number": "904-396-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD FORTUNE",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Christopher McDermott, ARNP
• Walter Francis McDermott, PH.D.
• Ryan McDevitt-Galles, CRNA
• Tegan Ann McDill, RD
• Dennis Joseph McDonagh, MD
• Edward McDonald Jr.
• Emily Allyson Dill McDonald, PHARMD
• Erin Marie McDonald, DIPL. OM., L'AC
• Frank Wilson McDonald, M.D.
• Jesse McDonald, PA

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.