DAVID M FANTLE MD
NPI 1205852613
Psychiatry & Neurology - Neurology in Salt Lake City, UT

Q: What is David Fantle's NPI number?

The NPI number for David Fantle is 1205852613. It was assigned to this individual provider in the NPPES registry on July 15, 2006.

Q: What is David Fantle's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for David Fantle was last updated on March 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 15, 2006PECOS Enrolled

400 C ST, SALT LAKE CITY, UT 84143(801) 408-8305 Get Directions Write a Review

NPPES record last updated: March 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About David M Fantle Md NPPES

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

DAVID M FANTLE MD (NPI 1205852613) is an individual neurology provider in Salt Lake City, Utah, licensed in Utah (3344141205) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205852613

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameDAVID M FANTLECredential: MD

Location Address400 C STSalt Lake City, UT 84143-1005

Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 408-8305

Phone(801) 408-8305

Sole ProprietorYes

Enumeration DateJuly 15, 2006

Last NPPES UpdateMarch 18, 2008

✔ NPI 1205852613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in UT · 3344141205

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

400 C ST, Salt Lake City, UT 84143

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David M Fantle Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84143 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.70 typical visit price

range $54.34 – $166.03

Typical copayment $31.42 (range $13.58 – $41.50)

Most-billed visit code 99204

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES F ORME MD

Internal Medicine (Critical Care Medicine)