Ethan Raphael Lafontaine, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11552 Issued in SC

Practice address

937 Riverwalk Pkwy Ste 101
Rock Hill, SC 29730-0179

Phone

(803) 325-1618

NPI assigned

Sep 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Neurosurgery and Spine Associates PAGroup PAC ID 7214833375, 104 clinicians

Atrium Health Neurospine Network LLCGroup PAC ID 1052800588, 121 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ethan.lafontaine.p1@direct.cnsa.nextgenshare.com
• FHIR API: https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Atrium Health Neurospine Network LLC

  • Neurological Surgery Physician
  • Charlotte, NC
  • NPI 1033007695

  SC

  Medicare reassignment Care Compare group NPD
• Carolina Neurosurgery & Spine Associates PA

  • Neurological Surgery Physician
  • Charlotte, NC
  • NPI 1154384568

  SC

  Medicare reassignment Care Compare group NPD
• Atrium Health Neurospine Network LLC

  • Neurological Surgery Physician
  • Rock Hill, SC
  • NPI 1831081454
  NPD
• Carolina Neurosurgery & Spine Associates PA

  • Neurological Surgery Physician
  • Rock Hill, SC
  • NPI 1548819170
  NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1689396640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 RIVERWALK PKWY STE 101",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300179",
            "telephone_number": "803-325-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14135 Ballantyne Corporate Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773668",
            "country_code": "US",
            "telephone_number": "704-831-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAFONTAINE",
        "first_name": "ETHAN",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-11-04",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21714",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ethan.LaFontaine.p1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dawn La Clair
• Bridgett M Laberge
• Anna Laboe
• Jason T Laboe
• Shebrea Ladson, BS, MSW
• Alexa Dawn Lagaly, FNP
• Jeffrey D Lahr, M.A., A.T.,C.
• Lake Wylie Serenity Homes LLC
• Lakeshore Palliative Care LLC
• Anthony Tricuong Lam, DO

• Physical Therapist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.