KENNETH GERALD FORTRESS (NPI# 1487650180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487650180 |
| Entity Type | Individual |
| Full Name | KENNETH GERALD FORTRESS |
| Credential | MD |
| Practice Address |
2400 South St Lafayette IN 47904-3027 |
| Mailing Address |
Po Box 5628 Lafayette IN 47903-5628 |
| Practice Telephone | 7654484319 |
| Practice Fax Number | 7654482921 |
| Mailing Telephone | 7654484319 |
| Mailing Fax Number | 7654482921 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
01032775A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000082508 | 01 |
| IN | MEDICARE | 111890C | 01 |
| IN | MEDICARE | 176600A | 01 |
| IN | 100259680A | 05 | |
| IN | RAIL ROAD MEDICARE | CA8380 | 01 |
| IN | RAIL ROAD MEDICARE | CB5232 | 01 |
| Street Address |
2400 SOUTH ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-3027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245569862 | Unity Healthcare, LLC | Anesthesiology | 2400 South St, Lafayette, IN 47904-3027 | 2009-12-10 |
| 1669636064 | Lafayette Neonatal Associates PC | Pediatrics | 2400 South St, Lafayette, IN 47904-3027 | 2008-07-15 |
| 1063632024 | Corry Lynn Voll | Occupational Therapist | 2400 South St, Home Hospital Rehabilitation Unit, Lafayette, IN 47904-3027 | 2007-05-01 |
| 1720108574 | North Central Health Services Inc. | Clinic/Center | 2400 South St, Lafayette, IN 47904-3027 | 2007-03-29 |
| 1003970971 | Arnett Clinic, LLC | Durable Medical Equipment & Medical Supplies | 2400 South St, Lafayette, IN 47904-3027 | 2006-12-21 |
| 1073686796 | Shannon Lyn Carroll | Dietitian, Registered | 2400 South St, Greater Lafayette Health Services Food and Nutrition, Lafayette, IN 47904-3027 | 2006-11-17 |
| 1922108133 | Robert Eugene Tipton | Pediatrics | 2400 South St, Home Hospital, Lafayette, IN 47904 | 2006-09-25 |
| 1518063452 | Rosario N Chua | Pediatrics | 2400 South St, Lafayette Home Hospital, Lafayette, IN 47904 | 2006-09-16 |
| 1134162274 | Jan Fisher | Anesthesiology | 2400 South St, Lafayette, IN 47904-3027 | 2006-06-14 |
| 1477507416 | Sameer Bhatia | Radiology | 2400 South St, Lafayette, IN 47904-3027 | 2006-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407299076 | Josh Anthony Showalter | Pathology | 1214 Coolidge Blvd Fl 3, Lafayette, LA 70503-2621 | 2013-04-12 |
| 1760403786 | Kelly S. Sorrells | Pathology | Umc Pathology, 2390 W Congress St, Lafayette, LA 70506 | 2006-07-23 |
| 1417953118 | Lee Allen Henderson | Pathology | 2400 South St., Department of Pathology, Lafayette, IN 47904 | 2005-06-27 |
| 1174967095 | Erin Eaton Langford | Pathology | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508 | 2013-04-22 |
| 1073808820 | Clinical Pathology Reliapath LLC | Pathology | 1810 Bertrand Dr, Lafayette, LA 70506-2055 | 2011-06-09 |
| 1730486382 | Reliapath LLC A Professional Medical Limited Liability Company | Pathology | 1810 Bertrand Dr, Lafayette, LA 70506-2055 | 2011-02-17 |
| 1639311079 | Richard Alan Owings II | Pathology | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2009-03-31 |
| 1013177575 | Zandra D'hue | Pathology | 5165 Mccarty Ln, Lafayette, IN 47905-8764 | 2008-06-09 |
| 1568596484 | Preferred Anatomic Pathology Services, Inc. | Pathology | 1214 Coolidge Blvd, Lafayette, LA 70503-2621 | 2007-03-15 |
| 1265504823 | Pecot & Padgett Apmc | Pathology | 217 La Rue France, Lafayette, LA 70508-3103 | 2006-11-15 |
| Find all providers in LAFAYETTE | ||||
Please comment or provide details below to improve the information on KENNETH GERALD FORTRESS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.