Individual provider Active NPI

Sylvia Renee Fountaine, NP-C

  • Family Nurse Practitioner
  • Katy, TX
National Provider Identifier
1184252074
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145673 Issued in TX
Practice address
24446 Dolce Marina CT
Katy, TX 77493-3978
Phone
(337) 274-8532
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP145673 TX Primary

Addresses

Primary practice location

24446 Dolce Marina CT
Katy, TX 77493-3978

Mailing address

23315 Brookdale Bay LN
Katy, TX 77493-3375
Phone (337) 274-8532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200929001080 TX Practitioner - Nurse Practitioner 9739508565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP145673TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Hybrid Pharmacy LLC CurrentSince Sep 20, 2020 Accepting new patients

Locations

545 Minonite Rd
Ste 110
Rosenberg, TX 77469
Phone (832) 930-8399

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1184252074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23315 BROOKDALE BAY LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774933375",
            "telephone_number": "337-274-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24446 DOLCE MARINA CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774933978",
            "telephone_number": "337-274-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAINE",
        "first_name": "SYLVIA",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.