Tanya Rose Fountain

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11657 Issued in OR

Practice address

780 Commercial St SE Ste 201
Salem, OR 97301-3463

Phone

(971) 599-3881

Fax

(503) 300-2848

NPI assigned

Jul 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tanya Fountain LLC

  • Clinical Social Worker
  • Salem, OR
  • NPI 1942025598
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1235338559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 COMMERCIAL ST SE STE 201",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013463",
            "telephone_number": "971-599-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 COMMERCIAL ST SE STE 201",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013463",
            "telephone_number": "971-599-3881",
            "fax_number": "503-300-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 Saginaw St S",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973024121",
            "country_code": "US",
            "telephone_number": "503-315-8646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "TANYA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Foster
• Daniel R Foster, MSW CSWA QMHP
• Jennifer Player Foster, P.A.-C.
• Mary A. Foster
• Melanie Foster
• Jessica Fouts, COTA
• Patricia Fowler, THW
• Alfred M Fox, SLP
• Delores Fox, RDH
• Kathryn Mary Fox, QMHA

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.