Individual provider Active NPI

Brooke Erin Fountain, FNP-BC

  • Family Nurse Practitioner
  • Royse City, TX
National Provider Identifier
1790344000
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140756 Issued in TX
Practice address
6257 FM 2642 Blvd
Royse City, TX 75189-3223
Phone
(469) 800-3670
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP140756 TX Primary

Addresses

Primary practice location

6257 FM 2642 Blvd
Royse City, TX 75189-3223

Mailing address

6257 FM 2642 Blvd
Royse City, TX 75189-3223
Phone (469) 800-3670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bfountain518792@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227001585 TX Practitioner - Nurse Practitioner 5991037988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

6257 FM 2642 Blvd
Suite 100
Royse City, TX 75189-3224
Phone (972) 635-9490

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP140756TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 27, 2024 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Dec 27, 2024 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1790344000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6257 FM 2642 BLVD",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751893223",
            "telephone_number": "469-800-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6257 FM 2642 BLVD",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751893223",
            "telephone_number": "469-800-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "BROOKE",
        "middle_name": "ERIN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bfountain518792@direct.sw.org",
            "affiliation": "N",
            "address_1": "6257 Fm 2642 Blvd",
            "city": "Royse City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751893223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royse City, TX

Sources for this page

Verify at the official NPI Registry.