Organization Active NPI

Fountain Health Inc.

  • Psychiatry Physician
  • Bensalem, PA
National Provider Identifier
1053631689
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FOUNTAIN HEALTH INC.
Practice address
3554 Hulmeville Rd Ste 106
Bensalem, PA 19020-4366
Phone
(215) 639-3185
Fax
(215) 639-3184
NPI assigned
Jun 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Dr. Emmanuel Ugwuoke, M.DNPI 1124204581
Title
President
Phone
(267) 266-6820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

3554 Hulmeville Rd Ste 106
Bensalem, PA 19020-4366

Mailing address

3554 Hulmeville Rd Ste 106
Bensalem, PA 19020-4366
Phone (215) 639-3185

Other practice location 1

2341 MacDade Blvd
Holmes, PA 19043-1301
Phone (215) 639-3185

Other practice location 2

17 Regency Plz
Glen Mills, PA 19342-1000
Phone (215) 639-3185

Other identifiers 1

IdentifierTypeStateIssuer
1024539660001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180620000297 PA Part B Supplier - Clinic/Group Practice 4385999101 Receives reassigned benefits from 1 practitioner
Practice locations: Bensalem, PA

National Provider Directory

National Provider Directory

Locations

3554 Hulmeville Rd
Ste 106
Bensalem, PA 19020
Phone (215) 639-3185

2341 Macdade Blvd
Holmes, PA 19043
Phone (215) 639-3185

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1275696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1053631689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3554 HULMEVILLE RD STE 106",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204366",
            "telephone_number": "215-639-3185",
            "fax_number": "215-639-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 HULMEVILLE RD STE 106",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204366",
            "telephone_number": "215-639-3185",
            "fax_number": "215-639-3184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2341 MacDade Blvd",
            "address_purpose": "LOCATION",
            "city": "Holmes",
            "state": "PA",
            "postal_code": "190431301",
            "country_code": "US",
            "telephone_number": "215-639-3185",
            "fax_number": "215-639-3184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Regency Plz",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421000",
            "country_code": "US",
            "telephone_number": "215-639-3185",
            "fax_number": "215-639-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUNTAIN HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-05",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "UGWUOKE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-266-6820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024539660001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.