GRADY A. FORTNER M.D. – NPI #1043636202
Emergency Medicine

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

GRADY FORTNER is a physician located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1043636202 to GRADY FORTNER on March 12, 2014. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207P00000X from the Health Care Provider Taxonomy code set, which is classified as Emergency Medicine.

The NPI profile was previously updated about 6 years ago on Dec 17, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRADY FORTNER below.

NPI Profile for
GRADY A. FORTNER

NPI Number
1043636202
Enumeration Date

(more than 12 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
GRADY A. FORTNER
Credentials
M.D.
Primary location
554 KEILY STREET
JACKSONVILLE, FL 32212
Phone: (757) 953-7550 Fax: (757) 953-7560
Mailing address
PO BOX 25578
BARRIGADA, GU 96921-5578
Phone: (671) 480-7934 Fax:
Sole Proprietor
Yes
Updated
Certification Date
Dec 17, 2019

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207P00000X
- Emergency Medicine (Primary)
VA 0116027243

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.