Active NPI
Tamika White Fountain
- Registered Nurse
- Euclid, OH
National Provider Identifier
1639571730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 401478
- Practice address
- 1744 Grand Blvd
Euclid, OH 44117-2277 - Phone
- (216) 563-2649
- NPI assigned
- Sep 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 401478 | OH | Primary |
Addresses
Primary practice location
1744 Grand Blvd
Euclid, OH 44117-2277
Mailing address
1744 Grand Blvd
Euclid, OH 44117-2277
Phone (216) 563-2649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401478 | OH | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Real Management LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Bigheart Home Health and Nursing Care
- Home Health Agency
- Cleveland, OH
- NPI 1003237686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1639571730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1744 GRAND BLVD",
"city": "EUCLID",
"state": "OH",
"postal_code": "441172277",
"telephone_number": "216-563-2649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1744 GRAND BLVD",
"city": "EUCLID",
"state": "OH",
"postal_code": "441172277",
"telephone_number": "216-563-2649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE FOUNTAIN",
"first_name": "TAMIKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-19",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "401478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.