Individual provider Active NPI

Christian Levy Fontenot

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1104665314
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
8611 Hillcrest Ave
Dallas, TX 75225-4203
Phone
(214) 251-8754
NPI assigned
May 20, 2024
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

8611 Hillcrest Ave
Dallas, TX 75225-4203

Mailing address

5123 N Hall St
Dallas, TX 75235-8815
Phone (225) 810-5727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240711000860 TX Practitioner - Physical Therapist in Private Practice 0345785663 Reassigns benefits to 1 organization
I20260616004673 LA Practitioner - Physical Therapist in Private Practice 0345785663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista JV Partners LLCGroup PAC ID 3274998224, 126 clinicians
Downtown Physical Therapy and Industrial Center LLCGroup PAC ID 0244329274, 5 clinicians

Practice addresses (Care Compare)

12228 N Central Expy
Suite 300
Dallas, TX 75243-3824
Phone (469) 706-3760

16645 Highland Rd
Suite L
Baton Rouge, LA 70810-6567
Phone (225) 756-2722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vista JV Partners LLC Physical Therapist CurrentSince Jun 24, 2024 Accepting new patients
Vista Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

3535 Travis St
Ste 160
Dallas, TX 75204
Phone (214) 346-9105

12228 N Central Expy
Ste 300
Dallas, TX 75243
Phone (469) 706-3760

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

6060 Rocky Point Trl
Ste 100
Lake Worth, TX 76135
Phone (682) 289-9840

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1104665314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 N HALL ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358815",
            "telephone_number": "225-810-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254203",
            "telephone_number": "214-251-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "CHRISTIAN",
        "middle_name": "LEVY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.