Kathleen P Fantozzi, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020015527 Issued in NH

Practice address

1590 Union St
Manchester, NH 03104-1768

Phone

(603) 860-8905

NPI assigned

Aug 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medcare NH LLC

  • Registered Nurse
  • Rochester, NH
  • NPI 1770250318
  Medicare reassignment NPD
• Minuteclinic Diagnostic of New Hampshire, L.L.C.

  • Family Nurse Practitioner
  • Concord, NH
  • NPI 1477894673
  NPD

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1861002701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 UNION ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031041768",
            "telephone_number": "603-860-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 UNION ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031041768",
            "telephone_number": "603-860-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTOZZI",
        "first_name": "KATHLEEN",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "2020015527",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "2020015527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Strategies and Services
• Family Support Services of NH
• Family Therapy Institute of Southern New Hampshire at Bedford, Inc.
• Familywell PLLC
• Allyson Lee Fanjoy, MSN, RN, AGNP
• Farrah Far
• Brian M Farina-Connors, RN
• Raphael Farra, M.D.
• Matthew Charles Farrell
• Shannon Marie Farrell, DMD

• Family Nurse Practitioner in Manchester, NH
• Providers in Manchester, NH by specialty
• Family Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.