Kelly Fountain, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME 129581 Issued in FL

Practice address

1223 Gateway Dr
Melbourne, FL 32901-2607

Phone

(321) 728-6002

NPI assigned

Jul 16, 2009

Last updated

May 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic RadiologyAlso: Nuclear Medicine

Education

University of South Alabama College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, 146 clinicians

Uchealth Imaging Services LLCGroup PAC ID 5799021291, 247 clinicians

Radiology and Imaging Consultants PCGroup PAC ID 1850298647, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
• Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326
• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008

Merit-based Incentive Payment System (MIPS)

Final score

82.92 of 100Reported as group

Quality

100

Improvement activities

40

Cost

43.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment Care Compare group NPD
• Radiology & Imaging Consultants PC

  • Diagnostic Radiology Physician
  • Colorado Springs, CO
  • NPI 1598700825
  Medicare reassignment Care Compare group NPD
• Uchealth Imaging Services, LLC

  • Diagnostic Radiology Physician
  • Broomfield, CO
  • NPI 1396210902
  Medicare reassignment Care Compare group NPD
• Lutheran Hospital Association of the San Luis Valley

  dba SLV Regional Medical Center

  • Surgery Physician
  • Del Norte, CO
  • NPI 1851579262
  NPD
• Uchealth Imaging Services, LLC

  • Diagnostic Radiology Physician
  • Highlands Ranch, CO
  • NPI 1043162142
  NPD
• Uchealth Imaging Services, LLC

  • Radiology Clinic/Center
  • Highlands Ranch, CO
  • NPI 1811551161
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1073172201
  Care Compare affiliation
• Uch-MHS

  dba UCHealth Emergency Room - Powers

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1124518113
  Care Compare affiliation
• Uch-MHS

  dba Memorial Health System

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1144397134
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1154030732
  Care Compare affiliation
• Uch-MHS

  dba UCHealth Emergency Room - Fountain

  • General Acute Care Hospital
  • Fountain, CO
  • NPI 1295225274
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1316506231
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1407532559
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1518526441
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1538958400
  Care Compare affiliation
• Uch-MHS

  dba UCHealth Emergency Room - Woodmen

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1578053567
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1598324428
  Care Compare affiliation

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589068800000",
    "number": "1700016359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 TURKEY POINT DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329348584",
            "telephone_number": "251-363-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-728-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "23930",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "30719",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0057830",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-37158",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 129581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA915",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Talitha Lawson Foster, OTR/L
• Thomas R Foster, MD
• Wesley McDaniel Foster, M.D.
• Evangelia Fotopoulos, M.D.
• Foundations Counseling, LLC.
• Corrine Ashley Fournier, OTR/L
• Irina Fout, LCSW
• Elizabeth Mae Fowler, M.D.
• Julie Lynn Fowler, MSW
• Kristina M Fowler, PT, DPT

• Diagnostic Radiology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.