Active NPI
Fanta Powell Labitue, M.D.
- Internal Medicine Physician
- Cincinnati, OH
National Provider Identifier
1437402716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 057554416
- Practice address
- 1118 Ryland Ave
Cincinnati, OH 45237-5126 - Phone
- (301) 213-6397
- NPI assigned
- Oct 24, 2012
- Last updated
- Oct 24, 2012
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 057554416 | GA | Primary |
Addresses
Primary practice location
1118 Ryland Ave
Cincinnati, OH 45237-5126
Mailing address
1118 Ryland Ave
Cincinnati, OH 45237-5126
Phone (301) 213-6397
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057554416 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1437402716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 RYLAND AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452375126",
"telephone_number": "301-213-6397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 RYLAND AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452375126",
"telephone_number": "301-213-6397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABITUE",
"first_name": "FANTA",
"middle_name": "POWELL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "057554416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.