TESFAYE D FANTA MD PLLC
NPI 1033489216
Internal Medicine - Endocrinology, Diabetes & Metabolism in Reidsville, NC

Active since January 05, 2012CLIA 34D0954419 · Waiver
910 W HARRISON ST, REIDSVILLE, NC 27320(336) 342-9564(336) 349-9723 Get Directions Write a Review

NPPES record last updated: January 5, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tesfaye D Fanta Md Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TESFAYE D FANTA MD PLLC (NPI 1033489216) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Reidsville, North Carolina and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through November 24, 2026 and lists Tesfaye Demissie Fanta, Owner, as its authorized official.

NPPES Registry Identity

NPI1033489216
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameTESFAYE D FANTA MD PLLC
Location Address910 W HARRISON STReidsville, NC 27320-3324
Mailing Address910 W Harrison StReidsville, NC 27320-3324 · (336) 342-9564 · Fax (336) 349-9723
Fax(336) 349-9723
Organization SubpartNo
Authorized OfficialTesfaye Demissie FantaOwner · (336) 342-9564
Enumeration DateJanuary 5, 2012
NPI 1033489216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in NC · 200900231
Definition

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.

910 W HARRISON ST, Reidsville, NC 27320

Other Identifiers 6

Other1522XNC · Bcbs
Medicaid891066ANC
Medicaid5911977NC
Medicare PIN2240802BNC
Other1066ANC · Bcbs
Medicare PIN2073533NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D0954419
Facility Type
Physician Office
Certificate Effective Date
November 25, 2024
Certificate Expiration Date
November 24, 2026
Laboratory Director
TESFAYE D. FANTA MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Tesfaye D Fanta Md Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for TESFAYE D FANTA MD PLLC

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Nurse Practitioner (Primary Care)
910 W HARRISON ST
REIDSVILLE, NC 27320

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033489216, enumerated as an "organization" on January 05, 2012.

The provider is located at 910 W HARRISON ST REIDSVILLE, NC 27320 and the phone number is (336) 342-9564.

Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.