Active NPI
De Adrea Dishonna Fontaine, ND
- Naturopath
- Gilbert, AZ
National Provider Identifier
1124441043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 13-1415
- Practice address
- 633 E Ray Rd Ste 110
Gilbert, AZ 85296-4202 - Phone
- (480) 666-5505
- Fax
- (469) 619-3245
- NPI assigned
- Jan 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 13-1415 | AZ | Primary |
Addresses
Primary practice location
633 E Ray Rd Ste 110
Gilbert, AZ 85296-4202
Mailing address
633 E Ray Rd Ste 110
Gilbert, AZ 85296-4202
Phone (480) 666-5505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13-1415 | AZ | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390953600000",
"number": "1124441043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 E RAY RD STE 110",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852964202",
"telephone_number": "480-666-5505",
"fax_number": "469-619-3245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 E RAY RD STE 110",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852964202",
"telephone_number": "480-666-5505",
"fax_number": "469-619-3245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTAINE",
"first_name": "DE ADREA",
"middle_name": "DISHONNA",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-29",
"last_updated": "2014-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "AZ",
"license": "13-1415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.