Fountain Family Medicine, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FOUNTAIN FAMILY MEDICINE, PA

Practice address

11701-32 San Jose Boulevard
Suite 103
Jacksonville, FL 32223

Phone

(904) 262-9075

NPI assigned

Jul 19, 2007

Last updated

Aug 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leanne Macdonald

Title

Office Manager

Phone

(904) 262-9075

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adria L Edenfield II, PA

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1629012182
  NPD
• Lorie R Carter, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1548596521
  NPD (past)
• Rebecca K Meiners, MD

  • Family Medicine Physician
  • Baton Rouge, LA
  • NPI 1740264514
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1124228119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701-32 SAN JOSE",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-262-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701-32 SAN JOSE BOULEVARD",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-262-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-262-9075"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siegrid Foster
• Summer Nicole Foster
• Fostering Behavior
• Fosuyi Enterprise (Rite-Mart Pharmacy)
• Foundations for Seniors, Inc
• Samaria Fountain
• Shenika Fountain, OTA
• Four Friends Fitness LLC
• Kayla Fouraker, M.S. SLP
• Lyndsey Lane Fournier, PA-C

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.