Active NPI
Kellie Leigh Fortier, PHARMD
- Pharmacist
- Mesa, AZ
National Provider Identifier
1992831507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13815
- Practice address
- 1400 S Dobson Rd
Mesa, AZ 85202-4707 - Phone
- (480) 412-5616
- Fax
- (480) 412-8763
- NPI assigned
- Feb 26, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13815 | AZ | Primary |
Addresses
Primary practice location
1400 S Dobson Rd
Mesa, AZ 85202-4707
Mailing address
4098 E Morrison Ranch Pkwy
Gilbert, AZ 85296-3091
Phone (480) 412-5616
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13815 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1992831507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4098 E MORRISON RANCH PKWY",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852963091",
"telephone_number": "480-412-5616",
"fax_number": "480-412-8763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707",
"telephone_number": "480-412-5616",
"fax_number": "480-412-8763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIER",
"first_name": "KELLIE",
"middle_name": "LEIGH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "13815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.