Individual provider Active NPI

Michael Lynn Fouts, RPH

  • Pharmacist
  • Douglasville, GA
National Provider Identifier
1306184767
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH009948 Issued in GA
Practice address
3316 Highway 5
Douglasville, GA 30135-2308
Phone
(770) 920-3466
Fax
(770) 489-6807
NPI assigned
Jan 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH009948 GA Primary

Addresses

Primary practice location

3316 Highway 5
Douglasville, GA 30135-2308

Mailing address

3316 Highway 5
Douglasville, GA 30135-2308
Phone (770) 920-3466

Other names 1

  • Michael Lynn Fouts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH009948GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc Past Accepting new patients
Publix Super Markets Inc Past Accepting new patients

Organizations & group practices 2

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": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1306184767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352308",
            "telephone_number": "770-920-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352308",
            "telephone_number": "770-920-3466",
            "fax_number": "770-489-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTS",
        "first_name": "MICHAEL",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH009948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "FOUTS",
            "middle_name": "LYNN",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2013; 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.