Active NPI
Brandy K Fountain, PHARM D
- Pharmacist
- Broadview, IL
National Provider Identifier
1326413352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051299105
- Practice address
- 800 Broadview Village SQ
Broadview, IL 60155-4887 - Phone
- (708) 731-5556
- Fax
- (708) 731-5566
- NPI assigned
- Dec 2, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051299105 | IL | Primary |
Addresses
Primary practice location
800 Broadview Village SQ
Broadview, IL 60155-4887
Mailing address
800 Broadview Village SQ
Broadview, IL 60155-4887
Phone (708) 731-5556
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051299105 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1326413352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 BROADVIEW VILLAGE SQ",
"city": "BROADVIEW",
"state": "IL",
"postal_code": "601554887",
"telephone_number": "708-731-5556",
"fax_number": "708-731-5566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 BROADVIEW VILLAGE SQ",
"city": "BROADVIEW",
"state": "IL",
"postal_code": "601554887",
"telephone_number": "708-731-5556",
"fax_number": "708-731-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUNTAIN",
"first_name": "BRANDY",
"middle_name": "K",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051299105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broadview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.