Jennifer Marie Bontreger, D.O.
Individual provider Active NPI Sports Medicine (Internal Medicine) Physician · Highland Village, TX
NPI 1679516652 · NPPES record last updated Dec 19, 2016
Key facts
- NPI
- 1679516652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Internal Medicine) Physician 207RS0010X
- License
- N4954 (TX)
- Practice address
- 2014 Justin Rd
Suite 104
Highland Village, TX 75077-7161 - Phone
- (469) 645-0200
- Fax
- (469) 637-0000
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120110000193 | TX | Practitioner - Internal Medicine |
4688699531 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N4954 | TX | MD | Sports Medicine (Internal Medicine) Physician |
Interoperability endpoints
- jennifer.bontreger@shhp.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/CJBDAD/Endpoint/CJBDAD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | N4954 | TX | Yes |
Addresses
Primary practice location
2014 Justin Rd
Suite 104
Highland Village, TX 75077-7161
Mailing address
2014 Justin Rd
Ste 104
Lewisville, TX 75077-7182
Phone (469) 645-0200
Other names
- Jennifer Marie Heist
Other providers in Highland Village, TX
- Martha Frances Bergen
- Lavonne Michelle Berner
- Megan Leigh Bittick
- Akosua Boatemaa
- Amelia Bogucki
- Melinda Hopson Bradley
- Brendan Hubbard, DDS, Ms, PLLC
- Callie Ann Britton
- Patricia Brooks
- Julie E Brown
All providers in Highland Village, TX · Sports Medicine (Internal Medicine) Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.