Individual provider Active NPI

Herbert Jerrel Fontenot, M.D.

  • Anesthesiology Physician
  • West Monroe, LA
National Provider Identifier
1285741777
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
018863 Issued in LA
Practice address
1275 Glenwood Dr
West Monroe, LA 71291-5539
Phone
(318) 322-1339
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 018863 LA Primary

Addresses

Primary practice location

1275 Glenwood Dr
West Monroe, LA 71291-5539

Mailing address

PO Box 678308
Dallas, TX 75267-8308
Phone (800) 897-6169

Other identifiers 2

IdentifierTypeStateIssuer
P00119325OtherLAMEDICARE RAILROAD
P00119325MedicaidLA

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

LicenseStateTypeSpecialty
018863LAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin City Anesthesia Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: herbert.fontenot.p1@direct.southernpain.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1285741777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678308",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678308",
            "telephone_number": "800-897-6169",
            "fax_number": "601-936-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 GLENWOOD DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915539",
            "telephone_number": "318-322-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "HERBERT",
        "middle_name": "JERREL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "018863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00119325",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P00119325",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.