Fountain Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FOUNTAIN HEALTHCARE LLC

Practice address

2876 Westerville Rd
Columbus, OH 43224-4463

Phone

(614) 772-5726

NPI assigned

Oct 19, 2022

Last updated

Nov 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Penny Macharia, RN

Title

Owner

Phone

(614) 772-5726

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528784626. Details of each certification follow.

• CCN 369375 Home health agency · Active · Details

Home health agency certification: CCN 369375

Legal name

FOUNTAIN HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 2, 2023

Last certification

Nov 30, 2023

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 5, 2022 in OH

Enrollment address

2876 Westerville Rd
Columbus, OH 43224-4463
HHA Branch

Listed as

Fountain Healthcare LLCCCN 369375 · All quality measures

Ownership

Proprietary

Certified

Dec 2, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1528784626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2876 WESTERVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432244463",
            "telephone_number": "614-772-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2876 WESTERVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432244463",
            "telephone_number": "614-772-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "MACHARIA",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-772-5726",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Columbus, OH
• Providers in Columbus, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.