Fountain Imaging of West Palm Beach

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

HCC4508 Issued in FL

Legal business name

FOUNTAIN IMAGING OF WEST PALM BEACH

Doing business as

Fountain Imaging

Practice address

5841 Corporate Way
Suite #101
West Palm Beach, FL 33407-2039

Phone

(561) 688-7309

Fax

(561) 688-7310

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By 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

Kristi Lynn Hebert

Title

Administrator

Phone

(561) 688-7309

Specialties & licenses 1

Addresses

Other names 1

• FOUNTAIN IMAGING Doing business as

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619033354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 CORPORATE WAY",
            "address_2": "SUITE #101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072039",
            "telephone_number": "561-688-7309",
            "fax_number": "561-688-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 CORPORATE WAY",
            "address_2": "SUITE #101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072039",
            "telephone_number": "561-688-7309",
            "fax_number": "561-688-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN IMAGING OF WEST PALM BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-688-7309"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC4508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUNTAIN IMAGING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Florida

• 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.