NPIMap

Individual provider Active NPI

Brett Fountaine, RPH

  • Pharmacist
  • Bozeman, MT
National Provider Identifier
1649679598
Registry record updated Aug 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2987 Issued in MT
Practice address
3255 Technology Blvd W
Bozeman, MT 59718-6854
Phone
(406) 587-4005
NPI assigned
Aug 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2987 MT Primary

Addresses

Primary practice location

3255 Technology Blvd W
Bozeman, MT 59718-6854

Mailing address

3255 Technology Blvd W
Bozeman, MT 59718-6854
Phone (406) 587-4005

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
2987MTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosauers Supermarkets Inc Past Accepting new patients
Rosauers Supermarkets Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408147200000",
    "number": "1649679598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 TECHNOLOGY BLVD W",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186854",
            "telephone_number": "406-587-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 TECHNOLOGY BLVD W",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186854",
            "telephone_number": "406-587-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAINE",
        "first_name": "BRETT",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-16",
        "last_updated": "2014-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "2987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; 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.