NPIMap

Individual provider Active NPI

Danielle Marie Fontaine, MD

  • Surgery Physician
  • Connelly Springs, NC
National Provider Identifier
1962865220
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2019-00201 Issued in NC
Practice address
730 Malcolm Blvd
Connelly Springs, NC 28612-8079
Phone
(828) 580-3572
NPI assigned
Apr 3, 2016
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2022031705 MO
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 2019-00201 NC Primary

Addresses

Primary practice location

730 Malcolm Blvd
Connelly Springs, NC 28612-8079

Mailing address

5221 Paramount Pkwy Ste 420
Morrisville, NC 27560-5491
Phone (984) 974-2705

Other practice location 1

10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000008 NC Practitioner - General Surgery 0345533493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Northeastern Ohio University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

730 Malcolm Blvd
Suite 100
Connelly Springs, NC 28612-8079
Phone (828) 580-7962

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jan 2, 2024 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jan 2, 2024 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. PastSince Mar 12, 2024 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Surgery PastSince Mar 12, 2024 Accepting new patients

Locations

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

2209 S Sterling St
Ste 530
Morganton, NC 28655
Phone (828) 580-4230

Organizations & group practices 5

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 4

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": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1962865220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 420",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605491",
            "telephone_number": "984-974-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MALCOLM BLVD",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128079",
            "telephone_number": "828-580-3572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10012 Kennerly Rd Ste 406",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282197",
            "country_code": "US",
            "telephone_number": "314-525-1224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2022031705",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2019-00201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connelly Springs, NC

Sources for this page

Verify at the official NPI Registry.