Caroline Gordy Fountain, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7134 Issued in MS

Practice address

13010 Hwy 18
Raymond, MS 39154-9526

Phone

(601) 857-2229

Fax

(601) 857-8223

NPI assigned

Aug 23, 2021

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Caroline Gordy Former name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aegis Group Practice LLC

  • Physical Therapist
  • Ridgeland, MS
  • NPI 1881271302
  Medicare reassignment Care Compare group NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Olive Branch, MS
  • NPI 1275392458
  NPD
• Performance Therapy LLC

  • Physical Therapist
  • Philadelphia, MS
  • NPI 1851427132
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030
  NPD

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1043987647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 WEST BEACON STREET",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "39350",
            "telephone_number": "601-650-0002",
            "fax_number": "601-650-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13010 HWY 18",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391549526",
            "telephone_number": "601-857-2229",
            "fax_number": "601-857-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "CAROLINE",
        "middle_name": "GORDY",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2023-10-30",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "GORDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Dooley, RPH
• Expect Therapy and Solutions, LLC (Expect Therapy & Solutions, LLC)
• Faithful Limbs Prosthetics
• First Choice Family Healthcare Clinic LLC
• First Family Healthcare Center, PLLC (Family First HeatlhCare Center)
• Lauren Freeman, PT
• Joni Gallman, CBD, PPD
• Katherine Gaynell Garrison, CRNA
• Hiram Alfonso Gatewood Jr., DMD
• Madena Jane Gibson, MD

• Physical Therapist in Raymond, MS
• Providers in Raymond, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.