Active NPI
Elisabeth Fontaine, MD
- Obstetrics & Gynecology Physician
- St Albans V, VT
National Provider Identifier
1184644437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 0420008922
- Practice address
- 12 Crest Rd
St Albans V, VT 05478 - Phone
- (802) 524-5523
- Fax
- (802) 524-5438
- NPI assigned
- Jul 20, 2006
- Last updated
- Oct 25, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 0420008922 | VT | Primary |
Addresses
Primary practice location
12 Crest Rd
St Albans V, VT 05478
Mailing address
12 Crest Rd
St Albans, VT 05478
Phone (802) 524-5523
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0VN0970 | Medicaid | VT |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420008922 | VT | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1184644437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 CREST RD",
"city": "ST ALBANS",
"state": "VT",
"postal_code": "05478",
"telephone_number": "802-524-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 CREST RD",
"city": "ST ALBANS V",
"state": "VT",
"postal_code": "05478",
"telephone_number": "802-524-5523",
"fax_number": "802-524-5438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTAINE",
"first_name": "ELISABETH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VT",
"license": "0420008922",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0VN0970",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.