William L Fontenot, MD
Individual provider Active NPI Orthopaedic Surgery Physician · Longview, TX
NPI 1730161886 · NPPES record last updated Dec 12, 2019
Key facts
- NPI
- 1730161886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- L0176 (TX)
- Practice address
- 709 Hollybrook Dr Ste 3401
Longview, TX 75605-2412 - Phone
- (903) 753-1778
- Fax
- (903) 753-7202
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- University of Texas Medical School at San Antonio, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Associated Clinicians of East Texas
Practice addresses (Care Compare)
709 Hollybrook Dr
Suite 3401
Longview, TX 75605-2412
Phone (903) 753-1778
Hospital & facility affiliations
- Onesource Home Care Inc
- Premier Home Care
- Highland Park Senior Care
- Longview Regional Medical Center
- Christus Good Shepherd Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 14 |
| Knee replacement | 25 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, 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 |
|---|---|---|---|---|
| I20080529000275 | TN | Practitioner - Orthopedic Surgery | 4587604194 | Reassigns benefits to 1 organization |
| I20200102000418 | TX | Practitioner - Orthopedic Surgery | 4587604194 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Clinicians of East Texas | Current |
Accepting new patients | |
| Amg-Crockett, LLC | Current |
Accepting new patients | |
| Amg-Crockett, LLC | Current |
Accepting new patients | |
| Amistad Physical Therapy Clinic, LLC | Past |
Accepting new patients | |
| Trinity Clinic | Past | Accepting new patients | |
| South West Texas Bone & Joint Institute | Orthopaedic Surgery | Past | Accepting new patients |
| Associated Clinicians of East Texas | Past | Accepting new patients |
Locations
1605 S Locust Ave
Ste 101
Lawrenceburg, TN 38464
Phone (931) 762-4400
1323 S Locust Ave
Lawrenceburg, TN 38464
Phone (931) 766-0077
106 S Military St
#B
Loretto, TN 38469
Phone (931) 853-4622
1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514
707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501
707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276
709 Hollybrook Dr
Ste 3401
Longview, TX 75605
Phone (903) 753-1778
Interoperability endpoints
- william.fontenot.1@23550.direct.athenahealth.com
- fontenot_william_l-md@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 43514 | TN | |
| Orthopaedic Surgery Physician | 207X00000X | L0176 | TX | Yes |
Addresses
Primary practice location
709 Hollybrook Dr Ste 3401
Longview, TX 75605-2412
Mailing address
PO Box 610393
Dallas, TX 75261-0393
Phone (903) 291-6187
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1503997 | Medicaid | TN |
Other providers in Longview, TX
- Elena Flores
- Mindy Lynn Flowers
- Folarin Health Services, PLLC
- Jonathan W Fontenot
- Monica Bridget Fontenot
- Wendy M. Fopay
- Brandy Sherell Ford
- Doris Elaine Ford
- Julie Marie Ford
- Cynthia Caroline Foster
All providers in Longview, TX · Orthopaedic Surgery 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 12, 2019. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.