Organization Active NPI

The Fountains Nursing Home Inc.

  • Skilled Nursing Facility
  • Boca Raton, FL
National Provider Identifier
1528063666
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1165096 Issued in FL
Legal business name
THE FOUNTAINS NURSING HOME INC.
Practice address
3800 N Federal Hwy
Boca Raton, FL 33431-4523
Phone
(561) 395-7510
Fax
(561) 395-1517
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Mr. Dennis L Mart
Title
Cfo
Phone
(585) 244-0410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1165096 FL Primary

Addresses

Primary practice location

3800 N Federal Hwy
Boca Raton, FL 33431-4523

Mailing address

3800 N Federal Hwy
Boca Raton, FL 33431-4523
Phone (561) 395-7510

Other identifiers 1

IdentifierTypeStateIssuer
021239300MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1528063666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314523",
            "telephone_number": "561-395-7510",
            "fax_number": "561-395-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314523",
            "telephone_number": "561-395-7510",
            "fax_number": "561-395-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOUNTAINS NURSING HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "MART",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-244-0410",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "1165096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021239300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.