Active NPI
Allison Marie Fortman I, SLP
- Speech-Language Pathologist
- Columbia, TN
National Provider Identifier
1972648830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2931
- Practice address
- 1224 Trotwood Ave
Columbia, TN 38401-4802 - Phone
- (931) 381-1111
- Fax
- (931) 380-4108
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2931 | TN | Primary |
Addresses
Primary practice location
1224 Trotwood Ave
Columbia, TN 38401-4802
Mailing address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT0000002931 | Other | TN | PT LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2931 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1972648830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 TROTWOOD AVE",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384014802",
"telephone_number": "931-381-1111",
"fax_number": "931-380-4108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 TROTWOOD AVE",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384014802",
"telephone_number": "931-381-1111",
"fax_number": "931-380-4108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTMAN",
"first_name": "ALLISON",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"name_suffix": "I",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "2931",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PT0000002931",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.