Kevin Michael Fountain, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004264 Issued in MI

Practice address

7 E Main St
Milan, MI 48160-1248

Phone

(734) 439-2020

Fax

(734) 439-2047

NPI assigned

Jul 20, 2006

Last updated

Aug 3, 2023By the provider in NPPES

Sex

Male

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 MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fountain Optometry, P.C.Group PAC ID 3678571916, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Fountain Optometry, P.C.

  • Optometrist
  • Milan, MI
  • NPI 1003991183
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1376563775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 E MAIN ST",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481601248",
            "telephone_number": "734-439-2020",
            "fax_number": "734-439-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 E MAIN ST",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481601248",
            "telephone_number": "734-439-2020",
            "fax_number": "734-439-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Alberto Enriquez, P T PC
• Brittany Fenrich
• Sondra Kay Ferenczy
• Mandy Lynn Foster, CPHT
• Fountain Optometry, P.C.
• Deborah M Fox
• Francis Medical Supplies
• Trina L Gale, LPC, NCC
• Paige Garcia Akiyama, LMSW
• Pamela Garcia, RD

• Optometrist in Milan, MI
• Providers in Milan, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.