Individual provider Active NPI

Holly Burris Fontenot, RN, MS, WHNP-BC

  • Women's Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1447485107
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
226670 Issued in MA
Practice address
130 Boylston St
Sidney Borum Health Center
Boston, MA 02116-4608
Phone
(617) 457-8140
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 226670 MA Primary

Addresses

Primary practice location

130 Boylston St
Sidney Borum Health Center
Boston, MA 02116-4608

Mailing address

130 Boylston St
Sidney Borum Health Center
Boston, MA 02116-4608
Phone (617) 457-8140

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
Master of Science, Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1447485107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BOYLSTON ST",
            "address_2": "SIDNEY BORUM HEALTH CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164608",
            "telephone_number": "617-457-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BOYLSTON ST",
            "address_2": "SIDNEY BORUM HEALTH CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164608",
            "telephone_number": "617-457-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "HOLLY",
        "middle_name": "BURRIS",
        "credential": "RN, MS, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "226670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.