Angelique Thais Fontenette, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

N8418 Issued in AR

Practice address

Jefferson Regional Medical Center
1600 West 40TH
Pine Bluff, AR 71603

Phone

(501) 541-7100

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenbrier Emergency Services, Inc.Group PAC ID 2668377359, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461

  AR

  Medicare reassignment Care Compare group NPD
• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323
  Medicare reassignment NPD
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1922475078
  Medicare reassignment NPD
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1467817411
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Conway Community Services

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1285005140
  Care Compare affiliation

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376695098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11810 SHADY RIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114589",
            "telephone_number": "501-228-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JEFFERSON REGIONAL MEDICAL CENTER",
            "address_2": "1600 WEST 40TH",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "501-541-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENETTE",
        "first_name": "ANGELIQUE",
        "middle_name": "THAIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AR",
            "license": "N8418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flowers Pharmacy
• Flowers Pharmacy LLC
• Heather Flowers, PHARMD
• John Alonzo Flowers Sr., M.D.
• Martha A Flowers, M.D.
• Renay Ford, RN
• Lee A Forestiere, M. D.
• Ashley Fort
• Fox-Stepps Therapy Services
• Fox-Trot Therapy Services

• Emergency Medical Services (Emergency Medicine) Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.