Active NPI
Diane Perine Fontana, CRNA
- Certified Registered Nurse Anesthetist
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 182054
- Practice address
- 200 Hawthorne LN
Charlotte, NC 28204-2515 - Phone
- (704) 384-4239
- Fax
- (704) 384-5636
- NPI assigned
- Jul 20, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2013006661 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 182054 | NC | Primary |
Addresses
Primary practice location
200 Hawthorne LN
Charlotte, NC 28204-2515
Mailing address
200 Hawthrone LN
Charlotte, NC 28204-2515
Phone (704) 384-4239
Other practice location 1
1 Barnes Jewish Hospital Plaza
Dept of Anesthesiology
St. Louis, MO 63110
Phone (800) 862-9980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8051588 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, SD
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000
Hospital & facility affiliations
- Barnes Jewish Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013006661 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sioux Falls Specialty Hospital, LLP | Current | Accepting new patients | |
| Metro-West Anesthesia Group Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Washington University | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients | |
| Sioux Falls Specialty Hospital, LLP | Current | Accepting new patients |
Locations
400 S Woods Mill Rd
Ste 140
Chesterfield, MO 63017
Phone (314) 485-1101
2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850
1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700
1 Barnes Jewish Hospital Plz
#P
Saint Louis, MO 63110
Phone (618) 474-1074
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
4960 Childrens Pl
Fl 2
Saint Louis, MO 63110
Phone (314) 362-1520
910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098
7600 S Minnesota Ave
Ste 202
Sioux Falls, SD 57108
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1528005642
-
- Anesthesiology Physician
- Chesterfield, MO
- NPI 1245427335
Nurse Anesthetist, Certified Registered
-
- Special Hospital
- Sioux Falls, SD
- NPI 1316946809
-
- Primary Care Clinic/Center
- Sioux Falls, SD
- NPI 1447780796
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1114926110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWTHRONE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042515",
"telephone_number": "704-384-4239",
"fax_number": "704-384-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWTHORNE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042515",
"telephone_number": "704-384-4239",
"fax_number": "704-384-5636"
}
],
"practiceLocations": [
{
"address_1": "1 Barnes Jewish Hospital Plaza",
"address_2": "Dept of Anesthesiology",
"address_purpose": "LOCATION",
"city": "St. Louis",
"state": "MO",
"postal_code": "63110",
"country_code": "US",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FONTANA",
"first_name": "DIANE",
"middle_name": "PERINE",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "2013006661",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "182054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8051588",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
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- Cynthia Arias Fongging, PT
- Kristina Fons, APRN, NNP-BC
- Benjamin Fonseca
- Christina Fontaine, M.S.P, CCC-SLP
- Katherine Fontana
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.