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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21977 | SC | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
225 ENTERPRISE BLVD SUITE 101 |
City | GREENVILLE |
State | SC |
Zip Code | 29615 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
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 |
Find all providers in zip 29615 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
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1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
1700403276 | Carolyn Lisa Fry | Nurse Practitioner | 500 Baylor Dr Apt Suite, Greenville, TX 75402-8005 | 2020-07-01 |
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 |
Find all providers in GREENVILLE |
City | GREENVILLE |
Zip Code | 29615 |
Please comment or provide details below to improve the information on MR. JACOB J FOUNTAIN.
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.