Individual provider Active NPI

Christy Fontana, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1629003231
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101048395 Issued in VA
Practice address
2117 McComas Way
Ste. 103
Virginia Beach, VA 23456-3908
Phone
(757) 668-6715
Fax
(757) 668-6680
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101048395 VA Primary

Addresses

Primary practice location

2117 McComas Way
Ste. 103
Virginia Beach, VA 23456-3908

Mailing address

2117 McComas Way
Ste. 103
Virginia Beach, VA 23456-3908
Phone (757) 668-6715

Other identifiers 7

IdentifierTypeStateIssuer
254588OtherVAALLIANCE,MDIPA,MAMSI
5417787860392EOtherVACIGNA
790610PMedicaidNC
56838OtherVIOPTIMA, FAMILY CARE,FAMIS
541778786OtherNCNC HEALTH
460098OtherVAANTHEM BCBS,HK,HK,FAMIS
6716911MedicaidVA

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

LicenseStateTypeSpecialty
0101048395VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Medical Group Inc Pediatrics Past Accepting new patients
Childrens Medical Group Inc Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629003231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 MCCOMAS WAY",
            "address_2": "STE. 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563908",
            "telephone_number": "757-668-6715",
            "fax_number": "757-668-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 MCCOMAS WAY",
            "address_2": "STE. 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563908",
            "telephone_number": "757-668-6715",
            "fax_number": "757-668-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "CHRISTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101048395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE,MDIPA,MAMSI",
            "identifier": "254588",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5417787860392E",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790610P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA, FAMILY CARE,FAMIS",
            "identifier": "56838",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC HEALTH",
            "identifier": "541778786",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS,HK,HK,FAMIS",
            "identifier": "460098",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6716911",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.