NPIMap

Individual provider Active NPI

Joseph Donald Fountain, DO

  • Family Medicine Physician
  • Milton, FL
National Provider Identifier
1225042864
Registry record updated Oct 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS13123 Issued in FL
Practice address
5907 Berryhill Rd
Milton, FL 32570-8278
Phone
(850) 623-9787
Fax
(850) 626-7512
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS8585 FL
Family Medicine Physician 207Q00000X OS13123 FL Primary

Addresses

Primary practice location

5907 Berryhill Rd
Milton, FL 32570-8278

Mailing address

5907 Berryhill Rd
Milton, FL 32570-8278
Phone (850) 623-9787

Other identifiers 4

IdentifierTypeStateIssuer
51546877OtherALBCBS OF AL
51546878OtherALBLUE CROSS BLUE SHIELD OF AL
267486600MedicaidFL
57900OtherFLFL BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000634 FL Practitioner - Family Practice 4688689250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Physician PartnersGroup PAC ID 5597751776, 5 clinicians

Practice addresses (Care Compare)

5907 Berryhill Rd
Milton, FL 32570-8278
Phone (850) 623-9787

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS8585FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Physician Partners Family Medicine CurrentSince Apr 6, 2015 Accepting new patients
Santa Rosa Hma Physician Management, LLC Family Medicine PastSince May 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Hma Santa Rosa Medical Center LLC Past Accepting new patients
Santa Rosa Hma Physician Management LLC Family Medicine PastSince Jul 4, 2021 Accepting new patients

Locations

5907 Berryhill Rd
Milton, FL 32570
Phone (850) 437-8711

Interoperability endpoints

  • Direct secure messaging: josephfountain@gcpp.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539388800000",
    "number": "1225042864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325708278",
            "telephone_number": "850-623-9787",
            "fax_number": "850-626-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5907 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325708278",
            "telephone_number": "850-623-9787",
            "fax_number": "850-626-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "JOSEPH",
        "middle_name": "DONALD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8585",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51546877",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF AL",
            "identifier": "51546878",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267486600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "57900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

Verify at the official NPI Registry.