Active NPI
Fachecia Laverne Fort, N.P.
- Adult Health Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1952602963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R193529
- Practice address
- 3900 Loch Raven Blvd
Baltimore, MD 21218-2108 - Phone
- (410) 605-7000
- NPI assigned
- Nov 8, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R193529 | MD | Primary |
Addresses
Primary practice location
3900 Loch Raven Blvd
Baltimore, MD 21218-2108
Mailing address
3900 Loch Raven Blvd
Baltimore, MD 21218-2108
Phone (410) 605-7000
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Oasis Healthcare Services LLC | Adult Health | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Adult Health Nurse Practitioner
- Mechanicsville, MD
- NPI 1346841236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1952602963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 LOCH RAVEN BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212182108",
"telephone_number": "410-605-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 LOCH RAVEN BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212182108",
"telephone_number": "410-605-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORT",
"first_name": "FACHECIA",
"middle_name": "LAVERNE",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-08",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MD",
"license": "R193529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.