TESFAYE D FANTA MD PLLC (NPI# 1033489216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033489216 |
| Entity Type | Organization |
| Organization Name | TESFAYE D FANTA MD PLLC |
| Practice Address |
910 W Harrison St Reidsville NC 27320-3324 |
| Practice Telephone | 3363429564 |
| Practice Fax Number | 3363499723 |
| Mailing Telephone | 3363429564 |
| Mailing Fax Number | 3363499723 |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |
| Authorized Official Name | DR. TESFAYE DEMISSIE FANTA (OWNER) |
| Authorized Official Telephone | 3363429564 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
200900231 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5911977 | 05 | |
| NC | BCBS | 1522X | 01 |
| NC | BCBS | 1066A | 01 |
| NC | 891066A | 05 |
| Street Address |
910 W HARRISON ST |
| City | REIDSVILLE |
| State | NC |
| Zip Code | 27320-3324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417576620 | Professional Vision Care, Od, Pllc | Optometrist | 1624 Nc #14 Highway, Reidsville, NC 27320 | 2020-04-09 |
| 1538796966 | Dabney Varner Porter | Speech-Language Pathologist | 613 S. Main St., Reidsville, NC 27320 | 2020-03-25 |
| 1053868463 | Marlon Nolen | Social Worker | 425 Nc-65, Reidsville, NC 27320 | 2016-09-01 |
| 1659741346 | Gepernard Tania Polidor | Social Worker | 405 Nc-65, Reidsville, NC 27320 | 2015-10-07 |
| 1548687064 | Angel Allen | Skilled Nursing Facility | 255 Penn Lake Dr, Reidsville, NC 27320 | 2014-03-21 |
| 1801234844 | Remmsco | Substance Abuse Rehabilitation Facility | 106 N. Franklin St, Reidsville, NC 27320 | 2013-06-12 |
| 1861733669 | The Free Clinic of Rockingham County, Inc | Clinic/Center | 315 S. Main Street, Reidsville, NC 27320 | 2013-03-05 |
| 1396094173 | Helen Elizabeth Brooks | Nurse Practitioner | 502 South Scales Street, Reidsville, NC 27320 | 2012-09-07 |
| 1952650327 | Ashlee Place | Assisted Living Facility | 538 Warriner Street, Reidsville, NC 27320 | 2012-08-31 |
| 1558638536 | Tracey Caroline Cook | Pharmacist | 1623 Way, Reidsville, NC 27320 | 2011-11-19 |
| Find all providers in zip 27320 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346450657 | Gebreselassie W Nida | Internal Medicine | 1107 S Main St, Reidsville, NC 27320-5313 | 2007-05-23 |
| 1780004556 | Moses Cone Physician Services Inc | Internal Medicine | 1107 S Main St, Reidsville, NC 27320-5313 | 2014-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184030595 | Eric Lewis | Internal Medicine | 306 Parkridge Ave, Chapel Hill, NC 27517-8137 | 2014-07-07 |
| 1588077176 | Greensboro Endocrinology Pllc | Internal Medicine | 7 Corporate Center Ct Ste C, Greensboro, NC 27408-3839 | 2014-06-11 |
| 1043656770 | Thomas Cary Cameron | Internal Medicine | Division of Endocrinology & Metabolism, 8025 Burnett Womack Building, Chapel Hill, NC 27599-7170 | 2013-05-21 |
| 1548556749 | Leah Elizabeth Kang-oh | Internal Medicine | 755 Highland Oaks Dr Suite 201, Winston-salem, NC 27103 | 2011-06-26 |
| 1558656702 | Diabetes Management Solutions | Internal Medicine | 1100 Navaho Dr Ste 249, Raleigh, NC 27609-7364 | 2011-06-16 |
| 1174813570 | Chinenyenwa Usoh | Internal Medicine | 4610 Country Club Rd, Winston Salem, NC 27104-3520 | 2011-04-19 |
| 1366745259 | Carolinas Physicians Network Inc | Internal Medicine | 908 Donita Drive, Lincolnton, NC 28092-3643 | 2010-12-15 |
| 1982916342 | Vengamamba Polu | Internal Medicine | 701 Doctors Dr Ste D, Kinston, NC 28501-1584 | 2010-07-13 |
| 1073838132 | Alexandria Atuahene Opata | Internal Medicine | 16525 Holly Crest Ln Ste 230, Huntersville, NC 28078-4912 | 2010-04-01 |
| 1376865519 | Novant Medical Group Inc | Internal Medicine | 16525 Holly Crest Lane, Suite 230, Huntersville, NC 28078-4912 | 2010-02-15 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 27320 |
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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.