Bradley Fortinberry (NPI# 1356891667, PAC ID# 6305129073) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1356891667 |
| PAC ID by PECOS | 6305129073 |
| Professional Enrollment ID | I20170203002545 |
| Full Name | Bradley Fortinberry |
| Organization Legal Name | FORTINBERRY PHYSICAL THERAPY LLC |
| Address |
709 Robb St Summit MS 39666-8241 |
| Phone Number | 6012762200 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 4981987658 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 709 Robb St, Summit, MS 39666-8241 | 6012762200 | FORTINBERRY PHYSICAL THERAPY LLC |
| Organization Legal Name | FORTINBERRY PHYSICAL THERAPY LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Fortinberry | Physical Therapy | Fortinberry Physical Therapy LLC | 709 Robb St, Summit, MS 39666-8241 |
| Michael Ray Dunaway Jr. | Physical Therapy | Fortinberry Physical Therapy LLC | 709 Robb St, Summit, MS 39666-8241 |
| Street Address |
709 ROBB ST |
| City | SUMMIT |
| State | MS |
| Zip | 39666-8241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Fortinberry | Physical Therapy | Fortinberry Physical Therapy LLC | 709 Robb St, Summit, MS 39666-8241 |
| Michael Ray Dunaway Jr. | Physical Therapy | Fortinberry Physical Therapy LLC | 709 Robb St, Summit, MS 39666-8241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph Lee Dykes | Nurse Practitioner | 7900 Ms Hwy 570 W, Summit, MS 39666 | |
| Karen Boone | Nurse Practitioner | Jennifer D Gholson Md, LLC | 804 Robb St, Summit, MS 39666-8291 |
| Jennifer D Gholson | Family Medicine | Jennifer D Gholson Md, LLC | 804 Robb St, Summit, MS 39666-8291 |
| Bente Johnson | Clinical Social Worker | 1009 Magnolia Pisgah Rd, Summit, MS 39666-9245 | |
| Jodi L Waller | Nurse Practitioner | Statcare Pllc | 105 S Laurel St, Suite A, Summit, MS 39666-9349 |
| City | SUMMIT |
| Zip Code | 39666 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | SUMMIT + PHYSICAL THERAPY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.