William L Fontenot (NPI# 1730161886, PAC ID# 4587604194) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1730161886 |
| PAC ID by PECOS | 4587604194 |
| Professional Enrollment ID | I20080529000275 |
| Full Name | William L Fontenot |
| Organization Legal Name | AMG-CROCKETT, LLC |
| Address |
106 S Military St B Loretto TN 38469-2100 |
| Phone Number | 9318534622 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO |
| Graduation Year | 1994 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 4789770199 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440175 | SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM LAWRENCE |
| Address | Phone | Organization |
|---|---|---|
| 106 S Military St, B, Loretto, TN 38469-2100 | 9318534622 | AMG-CROCKETT, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 3% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 5% |
| Organization Legal Name | AMG-CROCKETT, LLC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Racheal M Kightlinger | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| John P. Kristofich | Cardiovascular Disease (cardiology) | Amg-crockett, LLC | 1611 S Locust Ave, Suite 200b, Lawrenceburg, TN 38464-4055 |
| Alvin Matthew Maliakal | Internal Medicine | Amg-crockett, LLC | 184 Prosser Rd, Lawrenceburg, TN 38464-4233 |
| Katrina M. Dial | Certified Nurse Midwife (cnm) | Amg-crockett, LLC | 1605 S Locust Ave, Suite 101, Lawrenceburg, TN 38464-4053 |
| Tracey K Williams | Nurse Practitioner | Amg-crockett, LLC | 4955d Hwy 43 N, Mount Pleasant, TN 38474-5010 |
| Norman Mcnulty | Neurology | Amg-crockett, LLC | 1321 S Locust Ave, Lawrenceburg, TN 38464-4040 |
| Elbert G Warren | Obstetrics/gynecology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Haley Beecham Phillips | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Amanda D Haneline | Obstetrics/gynecology | Amg-crockett, LLC | 1605 S Locust Ave, Lawrenceburg, TN 38464-4053 |
| Brooke Huffsmith | Obstetrics/gynecology | Amg-crockett, LLC | 1605 S Locust Ave, Lawrenceburg, TN 38464-4053 |
| Street Address |
106 S MILITARY ST B |
| City | LORETTO |
| State | TN |
| Zip | 38469-2100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elbert G Warren | Obstetrics/gynecology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Marie Mattei-weiland | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Kelly C Baldwin | Urology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Whitney Brooke Franklin | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Nikki Lee Davenport | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Clayton D. Wilson | Family Practice | Amg-crockett, LLC | 106 S Military St, Loretto, TN 38469-2100 |
| Monica L Newton | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, Loretto, TN 38469-2100 |
| Jeffrey H Hernandez | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew E Schantz | Family Medicine | 206 S Military St, Suite 1, Loretto, TN 38469-2101 | |
| Emily V Gillespie | Nurse Practitioner | Ecm Health Group LLC | 722 N Military St, Loretto, TN 38469-2336 |
| Steven N Mashburn | Nurse Practitioner | Ecm Health Group LLC | 722 N Military St, Loretto, TN 38469-2336 |
| Johnathon L Jacobs Ii | Chiropractic | Loretto Family Chiropractic | 607 A N Military St, Loretto, TN 38469-2341 |
| Chasy Jacobs | Chiropractic | Loretto Family Chiropractic | 607 A N Military St, Loretto, TN 38469-2341 |
| City | LORETTO |
| Zip Code | 38469 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | LORETTO + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on William L Fontenot.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.