Active NPI
David Fontaine, M.D.
- Pediatrics Physician
- Fort Stewart, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- H8640
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314 - Phone
- (912) 435-6965
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | H8640 | TX | Primary |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H8640 | Other | TX | PHYSICIAN PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H8640 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients |
Locations
1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981
1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204
410 N M St
Hugo, OK 74743
Phone (580) 326-7561
902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100
2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Stigler, OK
- NPI 1184690026
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Broken Bow, OK
- NPI 1447143532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547769600000",
"number": "1861523409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314",
"telephone_number": "912-435-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTAINE",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2019-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "H8640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN PERMIT",
"identifier": "H8640",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.