MR. JACOB J FOUNTAIN


Address: 225 Enterprise Blvd, Suite 101, Greenville, SC 29615
Phone: 8644548120

MR. JACOB J FOUNTAIN (NPI# 1497232565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497232565
Entity Type Individual
Full Name MR. JACOB J FOUNTAIN
Credential FNP
Practice Address 225 Enterprise Blvd
Suite 101
Greenville
SC 29615
Mailing Address 100 W Faris Rd
Greenville
SC 29605-3002
Practice Telephone 8644548120
Mailing Telephone 9176966622
Enumeration Date 2018-07-23
Last Update Date 2018-07-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
21977 SC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 225 ENTERPRISE BLVD
SUITE 101
City GREENVILLE
State SC
Zip Code 29615

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1255816070 Trevis L Cureton Pharmacist 2401 East North St, Greenville, SC 29615 2018-09-27
1346726924 St. Francis Physician Services, Inc Internal Medicine 5 Hoke Smith Blvd, Greenville, SC 29615 2018-07-17
1558853101 Alexandra Michelle Taylor Audiologist 200 Patewood Dr Ste 400, Greenville, SC 29615 2018-05-30
1316466543 Mariah Hope Mosher Behavioral Analyst 7 Mckenna Commons Court, Greenvilee, SC 29615 2017-09-19
1326400896 Karen L Heaps Counselor 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 2016-03-24
1134589013 Sharon Erk Technician, Other 2950 E.norths St, Greenville, OH 29615 2016-03-04
1225400682 Cheryl Martinez Internal Medicine 65 International Drive, Greenville, SC 29615 2015-10-26
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1033744701 Jennifer C Carpenter Nurse Practitioner 2018 County Road 3318, Greenville, TX 75402-5268 2020-03-03
1659904183 Joante Kirk Nurse Practitioner 1699 S Main St, Greenville, MS 38701-7364 2020-02-12
1578103859 Michelle Earley Nurse Practitioner 4221 Ridgecrest Rd Ste 107, Greenville, TX 75402-6015 2020-01-14
1871138149 Paola Andrea Mora Tobon Nurse Practitioner 200 Patewood Dr Ste 320, Greenville, SC 29615-3593 2019-11-11
1144863895 Rashemia Latricia Suber Nurse Practitioner 814 Riviera Cir N, Greenville, MS 38701-8029 2019-10-25
1003460569 Shaun Fitzpatrick Nurse Practitioner Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 2019-08-01
1487116745 Megan Rogers Semanski Nurse Practitioner 890 W Faris Rd Ste 510, Greenville, SC 29605-4286 2019-04-04
1053884247 Renee L Bridges Nurse Practitioner 10 Enterprise Blvd Ste 202, Greenville, SC 29615-3554 2019-01-10
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Competitor

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City GREENVILLE
Zip Code 29615

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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