Ted R Fontanilla, MT

Primary specialty

SpecialistTaxonomy code 174400000X

License

11453 Issued in HI

Practice address

47-403 Ahuimanu Rd
Kaneohe, HI 96744-4850

Phone

(808) 239-9947

Fax

(808) 239-2213

NPI assigned

Oct 16, 2009

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902131428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47-403 AHUIMANU RD",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444850",
            "telephone_number": "808-239-9947",
            "fax_number": "808-239-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47-403 AHUIMANU RD",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967444850",
            "telephone_number": "808-239-9947",
            "fax_number": "808-239-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45-1144 Kamehameha Hwy",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967443244",
            "country_code": "US",
            "telephone_number": "808-236-1529",
            "fax_number": "808-236-0844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTANILLA",
        "first_name": "TED",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "HI",
            "license": "11453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James C Finley Jr., D.C.
• Jennifer Frances Finn, PHARMD
• Robert Stephen Fishman, PHD
• Fleurish and Grow
• Sergio G Florian
• Colleen M Fox, MA, MPH, PHD, CSAC
• Charlotte Ann Freeman, MS CCC SLP
• Fresenius Medical Care Oahu LLC (Fresenius Medical Care Windward)
• Francesca M. Freund, MAOM, L.AC.
• Douglas Frisbie

• Specialist in Kaneohe, HI
• Providers in Kaneohe, HI by specialty
• Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.