Active NPI
John T D'Antoni, MD
- Pediatrics Physician
- Longview, TX
National Provider Identifier
1336116169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- L3270
- Practice address
- 707 Hollybrook Dr
Longview, TX 75605-2410 - Phone
- (903) 757-6042
- Fax
- (903) 232-8226
- NPI assigned
- Mar 1, 2006
- Last updated
- May 28, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | L3270 | TX | Primary |
Addresses
Primary practice location
707 Hollybrook Dr
Longview, TX 75605-2410
Mailing address
707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 147532901 | Medicaid | TX |
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 |
|---|---|---|---|
| L3270 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diagnostic Clinic of Longview PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1336116169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 HOLLYBROOK DR",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756052410",
"telephone_number": "903-757-6042",
"fax_number": "903-232-8226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 HOLLYBROOK DR",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756052410",
"telephone_number": "903-757-6042",
"fax_number": "903-232-8226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'ANTONI",
"first_name": "JOHN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "L3270",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147532901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
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- D D McDonald MD & Associates
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- Dexter Berlin Dafney, DDS
- Padma Daggula
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.