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DR. GRADY REYNOLDS FORT M.D. NPI 1982765582


NPI Information

NPI: 1982765582
Provider Name: DR. GRADY REYNOLDS FORT, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Organization: MCCLOUD HEALTHCARE CLINIC, INC.

PECOS Registration: Yes

Address:
1140 MAIN ST
LIVINGSTON MEDICAL GROUP
LIVINGSTON, CA
ZIP 95334
Phone: (209) 394-7913
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DR. Grady Reynolds Fort, M.D. is a pediatrics in Livingston, CA with 52 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Grady Reynolds Fort, M.D. NPI is 1982765582. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduation Year:1972

The provider's business location address is:

1140 MAIN ST
LIVINGSTON MEDICAL GROUP
LIVINGSTON, CA
ZIP 95334-257
Phone: (209) 394-7913

The NPI 1982765582 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter (HCPCS:G0434)
  • Hemoglobin A1C level (HCPCS:83036)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 12/13/2006 and was last updated on 9/2/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsG27353CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A89449MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.