Terry Wayne Fonville, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

107804 Issued in NY

Practice address

99 University PL
Suite 201
New York, NY 10003-4528

Phone

(212) 222-7516

Fax

(212) 529-6222

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1154488831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 UNIVERSITY PL",
            "address_2": "SUITE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034575",
            "telephone_number": "212-222-7516",
            "fax_number": "212-529-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 UNIVERSITY PL",
            "address_2": "SUITE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034528",
            "telephone_number": "212-222-7516",
            "fax_number": "212-529-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONVILLE",
        "first_name": "TERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "107804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Fontanive, ATR-BC, LCAT
• Gabriela Fonteboa
• David Felipe Fontecilla Garcia, PA
• Nicole Fontenot
• Flannery Gregg Fontinell, RN, IBCLC, LCCE
• Erin Foo
• Farng-Yang Arvin Foo, MD
• James Fane Foo, DPT
• Li Foong Foo, MD
• Lilian Foo

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.