NICOLE MARIE FONTENOT DO
NPI 1376288233
Student in an Organized Health Care Education/Training Program in Southaven, MS

Q: What is Nicole Fontenot's NPI number?

The NPI number for Nicole Fontenot is 1376288233. It was assigned to this individual provider in the NPPES registry on May 4, 2022.

Q: What is Nicole Fontenot's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Fontenot was last updated on May 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 May 04, 2022PECOS Enrolled

7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671(662) 772-4696 Get Directions Write a Review

NPPES record last updated: May 4, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Nicole Marie Fontenot Do NPPES

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

NICOLE MARIE FONTENOT DO (NPI 1376288233) is an individual student in an organized health care education/training program in Southaven, Mississippi and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376288233

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameNICOLE MARIE FONTENOTCredential: DO

Location Address7601 SOUTHCREST PKWYSouthaven, MS 38671-4742

Mailing Address7601 Southcrest PkwySouthaven, MS 38671-4742 · (662) 772-4696

Phone(662) 772-4696

Sole ProprietorYes

Enumeration DateMay 4, 2022

NPPES CertifiedMay 4, 2022

✔ NPI 1376288233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

7601 SOUTHCREST PKWY, Southaven, MS 38671

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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)

Nicole Marie Fontenot Do 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.

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.

MID-SOUTH ANESTHESIA CONSULTANTS, PLLC

Specialist