Bryanne E Fountain

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9013-123 Issued in WI

Practice address

2500 Hall Avenue
Suite a
Marinette, WI 54143

Phone

(715) 732-7760

Fax

(715) 732-7711

NPI assigned

May 1, 2008

Last updated

Dec 8, 2021By the provider in NPPES

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

Other names 1

• Bryanne E Carow Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Marinette

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marinette, WI
  • NPI 1134237480
  NPD
• County of Marinette

  • Public Health or Welfare Agency
  • Marinette, WI
  • NPI 1205999653
  NPD

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1326214230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVENUE",
            "address_2": "SUITE A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVENUE",
            "address_2": "SUITE A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "BRYANNE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9013-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYANNE",
            "last_name": "CAROW",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willis Fisher, CRNA
• Jessica Marie Flaeschel, APNP
• J Bryan Flynn, MD
• Heather R Fochesato, APNP
• Forefront Dermatology, S.C.
• John Fredenburgh
• Emma Frederickson, DPT
• Jennifer J. Friday, NP
• Stephanie L Fries, MD
• Anthony N Friese, PT

• Clinical Social Worker in Marinette, WI
• Providers in Marinette, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.