Active NPI
Sandi Hopper Fontecchio, AU.D.
- Audiologist
- Saint Peters, MO
National Provider Identifier
1255581765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2008028914
- Practice address
- 4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606 - Phone
- (636) 441-3100
- NPI assigned
- Sep 22, 2008
- Last updated
- Jun 13, 2011
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2008028914 | MO | Primary |
Addresses
Primary practice location
4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Mailing address
4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1255581765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4790 EXECUTIVE CENTRE PKWY",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761606",
"telephone_number": "636-441-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4790 EXECUTIVE CENTRE PKWY",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761606",
"telephone_number": "636-441-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTECCHIO",
"first_name": "SANDI",
"middle_name": "HOPPER",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-22",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "2008028914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
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- Forever Diamond Home Care II LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.