Active NPI
Peter Michael Fantino, L.M.T.
- Specialist
- Fremont, OH
National Provider Identifier
1154457612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 33.011903
- Practice address
- 1110 E State St
Fremont, OH 43420-4358 - Phone
- (419) 307-1290
- Fax
- (419) 332-1668
- NPI assigned
- Feb 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 33.011903 | OH | Primary |
Addresses
Primary practice location
1110 E State St
Fremont, OH 43420-4358
Mailing address
709 Franklin Ave
Fremont, OH 43420-2003
Phone (419) 332-1668
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 |
|---|---|---|---|
| 33.011903 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154457612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 FRANKLIN AVE",
"city": "FREMONT",
"state": "OH",
"postal_code": "434202003",
"telephone_number": "419-332-1668",
"fax_number": "419-332-1668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 E STATE ST",
"city": "FREMONT",
"state": "OH",
"postal_code": "434204358",
"telephone_number": "419-307-1290",
"fax_number": "419-332-1668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANTINO",
"first_name": "PETER",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "L.M.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "33.011903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, OH
- Exigence of Fremont, LLC
- Eye Centers of Northwest Ohio Inc
- Eye Centers of Northwest Ohio LLC
- F O R M E Medical & Rehab Center of Fremont, Inc
- Family Medicine Associates of Sandusky Co LLC
- Alexandra Farmer, CDCA
- Scott James Farrell, MD
- Erica Febbo, APRN
- Timothy J Feehan Sr.
- Firelands Regional Medical Center (Firelands Couseling and Recovery Services)
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.