MS. JENNIFER H FORTENBERRY (NPI# 1609012368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609012368 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER H FORTENBERRY |
| Other Name | JENNIFER HANSHAW MCGOVERN |
| Credential | PA |
| Practice Address |
2401 Park Dr Ste 101 Harrisburg PA 17110-9303 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7176869842 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7178516969 |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2019-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
2002014284 | MO | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA056018 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2002014284 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD-FREEDOM BLUE | 2888522 | 01 |
| PA | GATEWAY MEDICARE ASSURED | 1620177 | 01 |
| Street Address |
2401 PARK DR STE 101 |
| City | HARRISBURG |
| State | PA |
| Zip Code | 17110-9303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356341366 | Jessica Holley Tweedy | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2005-08-01 |
| 1821567835 | Virginie Wandji Tokha | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2018-11-19 |
| 1437650546 | Landmark Connect of Pennslyvania PC | General Practice | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2018-02-23 |
| 1275032872 | Suzanne Lebeau | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2018-02-08 |
| 1689035982 | Landmark Medical of Pennsylvania PC | General Practice | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2016-03-14 |
| 1457725665 | Jill Madigan | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2015-11-26 |
| 1154795706 | Erin Stauffer | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2015-11-19 |
| 1821461062 | Christy Lepore | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2015-11-10 |
| 1790154482 | Cindyl Lee Mauzey | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2015-09-23 |
| 1124494869 | Kimngan Thi Velott | Nurse Practitioner | 2401 Park Dr Ste 101, Harrisburg, PA 17110-9303 | 2015-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457993271 | Christopher William Delong | Nurse Practitioner | 2501 North 3rd St. Fl 2, Harrisburg, PA 17110 | 2019-10-14 |
| 1306490701 | Melissa Ann Duchesne | Registered Nurse | 2501 North 3rd Street, Landis Building 7th Floor, Harrisburg, PA 17110 | 2019-07-25 |
| 1558845024 | Mary Kaitlin Novak | Counselor | 3605 Vartan Way, Suite 204a, Harrisburg, PA 17110 | 2018-09-20 |
| 1548781602 | Olson Orenson Knight | Internal Medicine | 2501 N. Third Street, Harrisburg, PA 17110 | 2017-06-29 |
| 1356897938 | Millonee Dialysis LLC | Clinic/Center | 4390 Sturbridge Dr, Harrisburg, PA 17110 | 2016-09-01 |
| 1538529268 | Ergency Associates LLC | Emergency Medical Technician, Basic | 2323 Linglestown Road, Unit 201b, Harrisburg, PA 17110 | 2016-02-23 |
| 1134514904 | Benjamin Daniel Chan | Student in an Organized Health Care Education/Training Program | Kline Health Center, 2501 N. Third St., 2nd Floor, Landis Building, Harrisburg, PA 17110 | 2015-03-30 |
| 1013317411 | Robert Derner Jr. | Counselor | 2700 Commerce Dr., Harrisburg, PA 17110 | 2014-09-04 |
| 1780029454 | Khem Kumar Adhikari | Family Medicine | 3601 North Progress Ave., Harrisburg, PA 17110 | 2013-05-07 |
| 1962791905 | Paul Schaffner Stoner Sr. | General Practice | 4500 Oakhurst Blvd., Apt 319, Harrisburg, PA 17110 | 2011-03-30 |
| Find all providers in zip 17110 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932591260 | Denise Ann Mesaros | Physician Assistant | 5071 Bass Lake Dr Apt 2003, Harrisburg, PA 17111-5918 | 2015-02-24 |
| 1003128547 | Maegan E Greenwade | Physician Assistant | 4200 Union Deposit Rd, Harrisburg, PA 17111-2801 | 2010-07-13 |
| 1356472799 | Jeffrey John Hollenbach | Physician Assistant | 4605 Locust Ln, Harrisburg, PA 17109-4424 | 2007-03-08 |
| 1598730483 | Joan Nerviano | Physician Assistant | 3601 N Progress Ave, Harrisburg, PA 17110-9100 | 2006-02-22 |
| 1649264268 | Marnie Irene Odonnell | Physician Assistant | 121 Nyes Rd, Harrisburg, PA 17112-3247 | 2005-09-09 |
| 1538791728 | Samantha Larsen | Physician Assistant | 111 S Front St, Harrisburg, PA 17101-2010 | 2020-02-06 |
| 1730721523 | Michalia Amony Humphrey | Physician Assistant | 2200 Dover Rd, Harrisburg, PA 17112-1002 | 2019-10-13 |
| 1619438926 | Justin Lanni | Physician Assistant | 111 S Front St, Harrisburg, PA 17101-2010 | 2019-03-28 |
| 1578017851 | Gretchen Moore | Physician Assistant | 4300 Londonderry Rd, Harrisburg, PA 17109-5317 | 2016-08-04 |
| 1134672660 | Anthony J Manney | Physician Assistant | 4300 Londonderry Rd Ste 302, Harrisburg, PA 17109 | 2016-08-02 |
| Find all providers in HARRISBURG | ||||
| City | HARRISBURG |
| Zip Code | 17110 |
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| 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.