TAYLOR FONTAINE (NPI# 1033593025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033593025 |
| Entity Type | Individual |
| Full Name | TAYLOR FONTAINE |
| Credential | PA-C |
| Practice Address |
1800 21st Ave S Fargo ND 58103-5759 |
| Practice Telephone | 7013658700 |
| Practice Fax Number | 7013658701 |
| Mailing Telephone | 7013658700 |
| Mailing Fax Number | 7013648701 |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 11875 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | PAC0603 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 Belsly Blvd, Moorhead, MN 565605055 | 2183646800 | 2182339267 |
| Street Address |
1800 21ST AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-5759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992803662 | Sue Karen Wink | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103-5759 | 2006-09-20 |
| 1104359769 | Sharlene Miller | Specialist/Technologist, Other | 1800 21st Ave S, Fargo, ND 58103-5759 | 2017-04-10 |
| 1528509288 | My Pt, Pllc | Clinic/Center | 1800 21st Ave S, Fargo, ND 58103-5759 | 2017-03-14 |
| 1881043768 | Ashley N Rogers | Audiologist | 1800 21st Ave S, Fargo, ND 58103-5759 | 2016-06-10 |
| 1326438649 | Jennifer Blais | Nurse Practitioner | 1800 21st Ave S, Fargo, ND 58103-5759 | 2015-01-26 |
| 1083962559 | Emily Richard | Hearing Instrument Specialist | 1800 21st Ave S, Fargo, ND 58103-5759 | 2012-08-15 |
| 1972862332 | Amy E Ulbricht | Nurse Practitioner | 1800 21st Ave S, Fargo, ND 58103-5759 | 2012-05-04 |
| 1952469165 | Susan M Mathison | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103 | 2006-12-04 |
| 1043378268 | Catalyst Medical Center PC | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103 | 2006-12-04 |
| 1730280892 | Morris E Bellis | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103-5759 | 2006-09-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033665310 | Caitlyn R Cameron | Physician Assistant | 4110 51st Ave South, Fargo, ND 58104 | 2016-08-28 |
| 1295069664 | Megan Jean Boose | Physician Assistant | 3173 43rd St S Ste A, Fargo, ND 58104-4564 | 2009-10-01 |
| 1487715405 | Nancy M Eastman | Physician Assistant | 4622 40th Ave S, Fargo, ND 58104-4394 | 2006-12-13 |
| 1700826369 | Jeanne Waalen | Physician Assistant | 4200 Woodhaven St Sw, Fargo, ND 58104-3946 | 2006-06-08 |
| 1982642773 | Linda K Regan | Physician Assistant | 1800 21st Avenue South, Fargo, ND 58103 | 2006-06-03 |
| 1437153905 | Jay R Metzger | Physician Assistant | 306 4th St N, Fargo, ND 58102-4820 | 2005-06-13 |
| 1538786728 | Peter V Tronset | Physician Assistant | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-03 |
| 1750908455 | Jordan Ann Wiedmann | Physician Assistant | 3201 33rd St S, Fargo, ND 58104-8823 | 2020-06-29 |
| 1144842089 | Matthew Hockert | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-05-14 |
| 1770110777 | Steffani Nicole Johnston Mack | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-03-27 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.