Individual provider Active NPI

Britney Foxworth Fontenot, PA-C

  • Physician Assistant
  • Ville Platte, LA
National Provider Identifier
1790968832
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200165 Issued in LA
Practice address
4940 Vidrine Rd
Ville Platte, LA 70586-2976
Phone
(337) 506-3500
NPI assigned
Dec 12, 2007
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA200165 LA Primary
Medical Physician Assistant 363AM0700X PA.200165 LA

Addresses

Primary practice location

4940 Vidrine Rd
Ville Platte, LA 70586-2976

Mailing address

4940 Vidrine Rd
Ville Platte, LA 70586-8780
Phone (337) 506-3500

Other identifiers 1

IdentifierTypeStateIssuer
1026671MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000499 LA Practitioner - Physician Assistant 0143302976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidrine Rural Health Clinic LLCGroup PAC ID 4587052782, 2 clinicians

Practice addresses (Care Compare)

4940 Vidrine Rd
Ville Platte, LA 70586-8780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA200165LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidrine Rural Health Clinic LLC PastSince Jan 3, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: britney.fontenot@vccllc.eclinicaldirectplus.com
  • Direct secure messaging: mrmbfont5@yourcarecommunity.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1790968832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 VIDRINE RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705868780",
            "telephone_number": "337-506-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VIDRINE RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705862976",
            "telephone_number": "337-506-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "BRITNEY",
        "middle_name": "FOXWORTH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-12",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200165",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026671",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.