Ednita Charzette Street Fountain, DNP, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

901702 Issued in MS

Practice address

1421 N 7TH St
Terre Haute, IN 47807-1005

Phone

(812) 231-4608

Fax

(812) 231-4675

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in IN, MS2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iceland Anesthesia Management LLCGroup PAC ID 7618372996, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
• Union Hospital Clinton Hospital, Clinton, IN, CCN 151326

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Iceland Anesthesia Management, LLC

  • Anesthesiology Physician
  • Terre Haute, IN
  • NPI 1912578667

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Clinical Colleagues Inc

  • Anesthesiology Physician
  • Van Wert, OH
  • NPI 1992725766

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Union Hospital Inc.

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1619975331
  Care Compare affiliation
• Union Hospital, Inc

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1821859752
  Care Compare affiliation
• Union Hospital, Inc.

  dba Union Hospital Clinton

  • Critical Access Hospital
  • Clinton, IN
  • NPI 1306844519
  Care Compare affiliation
• West Central Community Hospital

  • General Acute Care Hospital
  • Clinton, IN
  • NPI 1093713802
  Care Compare affiliation

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1578141024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 BASIN REFUGE RD",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394527688",
            "telephone_number": "601-947-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071005",
            "telephone_number": "812-231-4608",
            "fax_number": "812-231-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "EDNITA",
        "middle_name": "CHARZETTE STREET",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-06-16",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "889173",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forward by Highland
• Avery Foster
• Stephanie Fougerousse, DO
• James H Foulkes, DDS
• Fountain of Youth, LLC (Seelyville Family Practice)
• Kirsten Marie Fox, LCSW
• Angela Kay Francis, M.S., CCC-SLP
• Kacey Franklin
• Kayla Franklin, RBT
• Benjamin Bradford Fraser, ATC, LAT, CSCS

• Certified Registered Nurse Anesthetist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.