Individual provider Active NPI

Susan Kaye Fontana, D.C.

  • Chiropractor
  • Evergreen, CO
National Provider Identifier
1124142682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3977 Issued in CO
Practice address
4009 Evergreen Parkway
Evergreen, CO 80439
Phone
(303) 674-1500
Fax
(303) 674-4413
NPI assigned
Mar 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3977 CO Primary

Addresses

Primary practice location

4009 Evergreen Parkway
Evergreen, CO 80439

Mailing address

4009 Evergreen Parkway
Evergreen, CO 80439
Phone (303) 674-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130605000156 CO Practitioner - Chiropractic 2264670488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4009 Evergreen Pkwy
Evergreen, CO 80439-7765
Phone (303) 674-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3977COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
S & P Healing Arts, PLLC Chiropractor CurrentSince Mar 1, 2020 Accepting new patients

Locations

4009 Evergreen Pkwy
Evergreen, CO 80439
Phone (303) 674-1500

Organizations & group practices 1

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124142682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 EVERGREEN PARKWAY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-674-1500",
            "fax_number": "303-674-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 EVERGREEN PARKWAY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-674-1500",
            "fax_number": "303-674-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "SUSAN",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.