Active NPI
David F Fantelli, M.D.
- Internal Medicine Physician
- Kent, OH
National Provider Identifier
1326026774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35082755
- Practice address
- 307 W Main St
Suite B
Kent, OH 44240-2400 - Phone
- (330) 678-7782
- Fax
- (330) 678-7301
- NPI assigned
- Jan 5, 2006
- Last updated
- Mar 22, 2011
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35082755 | OH | Primary |
Addresses
Primary practice location
307 W Main St
Suite B
Kent, OH 44240-2400
Mailing address
307 W Main St
Suite B
Kent, OH 44240-2400
Phone (330) 678-7782
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2481854 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240328003258 | OH | Order and Referring Only - Internal Medicine | 7810978939 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35082755 | OH | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1326026774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 W MAIN ST",
"address_2": "SUITE B",
"city": "KENT",
"state": "OH",
"postal_code": "442402400",
"telephone_number": "330-678-7782",
"fax_number": "330-678-7301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 W MAIN ST",
"address_2": "SUITE B",
"city": "KENT",
"state": "OH",
"postal_code": "442402400",
"telephone_number": "330-678-7782",
"fax_number": "330-678-7301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANTELLI",
"first_name": "DAVID",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35082755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2481854",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, OH
- Fairchild (MD) Leasing Co., LLC (Kent Healthcare Center)
- Family & Community Services, Inc
- Family and Community Services, Inc.
- Family Foot Care Center LLC
- Familycare Home Health
- Pamela O Farer-Singleton, PH.D.
- Steven Allen Farr, PEER SUPPORTER
- Tara Farrell, LPC
- Jennifer M Fath, DPM
- John C Faulstick, ATC LAT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.