Active NPI
Leah Fountain
- Other Technician
- Jackson, MI
National Provider Identifier
1659931434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 1001 Laurence Ave
Jackson, MI 49202-2979 - Phone
- (517) 750-4777
- NPI assigned
- Jun 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
1001 Laurence Ave
Jackson, MI 49202-2979
Mailing address
100 Armory CT Apt 221
Jackson, MI 49202-3584
Phone (616) 422-6884
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1659931434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 ARMORY CT APT 221",
"city": "JACKSON",
"state": "MI",
"postal_code": "492023584",
"telephone_number": "616-422-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 LAURENCE AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492022979",
"telephone_number": "517-750-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUNTAIN",
"first_name": "LEAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-14",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.