Individual provider Active NPI

Jessica Denise Fortune, DPT

  • Physical Therapist
  • Laurinburg, NC
National Provider Identifier
1982375358
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047491 Issued in NY
Practice address
620 Johns Rd
Laurinburg, NC 28352-5128
Phone
(910) 276-8400
NPI assigned
Sep 24, 2021
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P23923 NC
Physical Therapist 225100000X 047491 NY Primary

Addresses

Primary practice location

620 Johns Rd
Laurinburg, NC 28352-5128

Mailing address

20 Lake St
Tupper Lake, NY 12986-1604
Phone (518) 524-2603

Other practice location 1

2568 Ny-212
Woodstock, NY 12498
Phone (845) 679-9767

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fortuj2@sage.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230329002991 AK Practitioner - Physical Therapist in Private Practice 0143612531 Reassigns benefits to 1 organization
I20260428001248 NC Practitioner - Physical Therapist in Private Practice 0143612531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breakthrough Physical Therapy IncGroup PAC ID 9234274754, 110 clinicians

Practice addresses (Care Compare)

275 Pinehurst Ave
Southern Pines, NC 28387-7051
Phone (910) 603-2788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P23923NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy Inc Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
Apexnetwork New Mexico, LLC Physical Therapist CurrentSince Dec 29, 2021 Accepting new patients

Locations

1917 Abbott Rd
Ste 200
Anchorage, AK 99507
Phone (907) 279-4266

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

140 E Highway 550
Ste E3
Bernalillo, NM 87004
Phone (505) 404-8652

204 W Broadway Ave
#A
Bloomfield, NM 87413
Phone (505) 333-7217

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1982375358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LAKE ST",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861604",
            "telephone_number": "518-524-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHNS RD",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525128",
            "telephone_number": "910-276-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2568 NY-212",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "NY",
            "postal_code": "12498",
            "country_code": "US",
            "telephone_number": "845-679-9767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "JESSICA",
        "middle_name": "DENISE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23923",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fortuj2@sage.edu",
            "affiliation": "N",
            "endpointDescription": "Professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2568 NY-212",
            "city": "Woodstock",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laurinburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.