Joanne Ellen Fountaine, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

114453 Issued in OH

Practice address

8414 Washington Village Dr
Centerville, OH 45458-1845

Phone

(937) 248-9349

NPI assigned

Sep 8, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ultimate Success Inc

  • Clinical Medical Laboratory
  • Saint Paul, MN
  • NPI 1548926173
  NPD Authorized official

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1346573433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 WASHINGTON VILLAGE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454581845",
            "telephone_number": "937-248-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 WASHINGTON VILLAGE DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454581845",
            "telephone_number": "937-248-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAINE",
        "first_name": "JOANNE",
        "middle_name": "ELLEN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "114453",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L41519-0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Forman, PTA
• Stephen Fortson, ED.D. PCC-S
• Jennifer Rodriguez Foster, PA-C
• Michelle Foster, PTA
• Norah Anne Foster, M.D.
• Amanda Ann Fox, NP-C
• Matthew John Fox, M.D.
• Allison Christine Fralick, D.O.
• Everlina M Frazier
• Freedom Health Center

• Licensed Practical Nurse in Centerville, OH
• Providers in Centerville, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.