Active NPI
Sylvia Renee Fountaine, NP-C
- Family Nurse Practitioner
- Katy, TX
National Provider Identifier
1184252074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP145673
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200929001080 | TX | Practitioner - Nurse Practitioner | 9739508565 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP145673 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brazos Hybrid Pharmacy LLC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.