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DR. MATTHEW SHANE FONTENOT M.D. NPI 1013985530


NPI Information

NPI: 1013985530
Provider Name: DR. MATTHEW SHANE FONTENOT, M.D.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

Organization: COOLIDGE PHYSICIAN SERVICES LLC

PECOS Registration: Yes

Address:
1214 COOLIDGE BLVD
LAFAYETTE, LA
ZIP 70503
Phone: (337) 289-7927
Get Directions

DR. Matthew Shane Fontenot, M.D. is a nephrology internal medicine in Lafayette, LA with 24 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Matthew Shane Fontenot, M.D. NPI is 1013985530. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduation Year:2000

The provider's business location address is:

1214 COOLIDGE BLVD
LAFAYETTE, LA
ZIP 70503-621
Phone: (337) 289-7927
Fax: (337) 289-7935

The NPI 1013985530 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/10/2006 and was last updated on 8/4/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrology024987LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14J90JCM76MEDICARE ID-TYPE UNSPECIFIEDLOUISIANAGROUP 5CM76

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.