Active NPI
Konstantinos Fountas, M.D.
- Neurological Surgery Physician
- Macon, GA
National Provider Identifier
1801243894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 76112
- Practice address
- 840 Pine St
Suite 880
Macon, GA 31201-2100 - Phone
- (478) 743-7092
- Fax
- (478) 743-7320
- NPI assigned
- May 19, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 76112 | GA | Primary |
Addresses
Primary practice location
840 Pine St
Suite 880
Macon, GA 31201-2100
Mailing address
840 Pine St
Suite 880
Macon, GA 31201-2100
Phone (478) 743-7092
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76112 | GA | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1801243894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 PINE ST",
"address_2": "SUITE 880",
"city": "MACON",
"state": "GA",
"postal_code": "312012100",
"telephone_number": "478-743-7092",
"fax_number": "478-743-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 PINE ST",
"address_2": "SUITE 880",
"city": "MACON",
"state": "GA",
"postal_code": "312012100",
"telephone_number": "478-743-7092",
"fax_number": "478-743-7320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUNTAS",
"first_name": "KONSTANTINOS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "GA",
"license": "76112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.