Fountain Foot Clinic PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

218 Issued in NE

Legal business name

FOUNTAIN FOOT CLINIC PC

Practice address

5835 Vine St
Lincoln, NE 68505-2847

Phone

(402) 466-5677

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dale Meier Fountain, D.P.M.

Title

Owner

Phone

(402) 466-5677

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578765087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5835 VINE ST",
            "address_2": "PO BOX 5505",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052847",
            "telephone_number": "402-466-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 VINE ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052847",
            "telephone_number": "402-466-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN FOOT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "MEIER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-466-5677",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505963785",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MC",
            "identifier": "480013496",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty D Foster, RN
• William Foster
• Amy Fotopulos
• Hayley Fouche
• Gregory Fought, D.D.S.
• Dale Meier Fountain, DPM
• Garrett Fountain
• Scott Danial Fountain
• Four Star Drug of Bethany Inc (Four Star Drug)
• Four Star Drug of Lincoln Nebraska Inc (Four Star Drug)

• Podiatrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Podiatrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.