Fountains Infusion Center of Little Rock, LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

FOUNTAINS INFUSION CENTER OF LITTLE ROCK, LLC

Practice address

15200 Chenal Pkwy Ste 300
Little Rock, AR 72211

Phone

(501) 451-6080

Fax

(501) 451-6081

NPI assigned

Jun 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George Wade Phillips

Title

Owner

Phone

(601) 859-8200

Specialties & licenses 1

Addresses

Other names 1

• Fountains Infusion Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cassandra Michelle Cole, M.D.

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1700104148

  AR

  Medicare reassignment Care Compare group NPD
• Callie Reynolds, APRN

  • Acute Care Nurse Practitioner
  • Little Rock, AR
  • NPI 1093174716

  AR

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1023747102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 CHENAL PKWY STE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72211",
            "telephone_number": "501-451-6080",
            "fax_number": "501-451-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 CHENAL PKWY STE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72211",
            "telephone_number": "501-451-6080",
            "fax_number": "501-451-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAINS INFUSION CENTER OF LITTLE ROCK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-859-8200"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountains Infusion Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whitney Foster
• Beverly Massey Foti, L.P.E.
• Wendy D Founds
• Dearius Fountain, QBHP
• Trenn Devor Fountain Sr.
• Four Seasons Allergy and Asthma Clinic PA
• Marcelle Theresa Fournet
• Trenten Foust, MHPP
• Caitlin Cecilia Fowler, APRN
• Christopher Wade Fowler, DO

• Infusion Therapy Clinic/Center in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Infusion Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.