AMANDA FANTRY (NPI# 1992098123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992098123 |
| Entity Type | Individual |
| Full Name | AMANDA FANTRY |
| Credential | M.D. |
| Practice Address |
1000 Asylum Ave Ste 2126 Hartford CT 06105 |
| Mailing Address |
1000 Asylum Ave Ste 2126 Hartford CT 06105-1718 |
| Practice Telephone | 8607286740 |
| Practice Fax Number | 8605471554 |
| Mailing Telephone | 8607286740 |
| Mailing Fax Number | 8605471554 |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2018-06-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MD15395 | RI | Allopathic & Osteopathic Physicians |
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
61342 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3900 Junius St Ste 500, Dallas, TX 752461621 | 4698007245 | 4698007470 |
| Street Address |
1000 ASYLUM AVE STE 2126 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316366792 | Matthew J Grosso | Orthopaedic Surgery | 1000 Asylum Ave Ste 2126, Hartford, CT 06105-1719 | 2014-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1730743568 | Turab J Mohammed | Student in an Organized Health Care Education/Training Program | Saint Francis Hospital Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2019-04-26 |
| 1164900387 | Breanne Ferrara | Social Worker | 43 Wooland St, Hartford, CT 06105 | 2018-07-31 |
| 1154814069 | Signature Smiles of Hartford LLC | Dentist | 550 Farmington Avenue, Suite B, Hartford, CT 06105 | 2018-06-14 |
| 1356839062 | Jaimy Villavicencio | Student in an Organized Health Care Education/Training Program | 100 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2018-04-27 |
| 1750885679 | Brittany Bird | Student in an Organized Health Care Education/Training Program | 839-841 Asylum Avenue, Hartford, CT 06105 | 2018-03-23 |
| 1972032241 | Ashley Nicole Mills | Student in an Organized Health Care Education/Training Program | 896 Asylum Ave, 3rd Floor, Hartford, CT 06105 | 2017-06-08 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1841735818 | Katie Strahowski | Nurse Practitioner | 85 Gillett Street, Clean Slate, Hartford, CT 06105 | 2016-12-30 |
| Find all providers in zip 06105 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700207198 | Connecticut Orthopaedic Specialists, PC | Orthopaedic Surgery | 12 Bokum Rd, Essex, CT 06426-1500 | 2014-01-02 |
| 1144514522 | Adam Quinn Ferguson | Orthopaedic Surgery | 863 N Main Street Ext Ste 200, Wallingford, CT 06492-2434 | 2011-06-03 |
| 1497935191 | William G. Cimino, Md, PC | Orthopaedic Surgery | 52 Beach Rd, #207, Fairfield, CT 06824-6017 | 2007-11-09 |
| 1184828105 | Connecticut Orthopaedic Specialists, PC | Orthopaedic Surgery | 450 Boston Post Rd, Guilford, CT 06437-2933 | 2007-06-13 |
| 1578595237 | Gary Richard Richo | Orthopaedic Surgery | 2 Trap Falls Rd Ste 404, Shelton, CT 06484-7622 | 2006-07-06 |
| 1154375525 | Adam Brodsky | Orthopaedic Surgery | 166 Cherry St, Suite B, New Canaan, CT 06840-4828 | 2006-05-20 |
| 1295700441 | Dr R Hillsman Md PC | Orthopaedic Surgery | 1183 New Haven Rd, Dr. R. Hillsman, PC, Naugatuck, CT 06770-5033 | 2006-02-21 |
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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.