Fountain of Youth MD, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOUNTAIN OF YOUTH MD, LLC

Practice address

200 Galleria Pkwy SE
100
Atlanta, GA 30339-5918

Phone

(404) 382-9277

NPI assigned

Dec 26, 2012

Last updated

Dec 26, 2012By 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

Dr. Offer Danan, DCNPI 1598009342

Title

Owner

Phone

(770) 695-5500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Offer Danan, D.C.

  • Chiropractor
  • Atlanta, GA
  • NPI 1598009342
  NPD Authorized official

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1558607374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GALLERIA PKWY SE",
            "address_2": "100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GALLERIA PKWY SE",
            "address_2": "100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395918",
            "telephone_number": "404-382-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF YOUTH MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "DANAN",
        "authorized_official_first_name": "OFFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-695-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foundation Therapy Center - North Atlanta, LLC
• Foundations Atlanta, LLC
• Fountain Family Inc (Homewatch CareGivers Atlanta East)
• Fountain Oaks Dental P.C.
• Fountain of Youth MD LLC
• Alison Virginia Fountain, M.D.
• Chelsea E Fountain
• Faith A Fountain
• Joshua Shane Fountain
• Linda M Fountain, MD

• Durable Medical Equipment & Medical Supplies in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.