Fountain Medical Group SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

FOUNTAIN MEDICAL GROUP SC

Practice address

15 W Pleasant Ave
Sandwich, IL 60548-1050

Phone

(815) 786-2101

Fax

(815) 786-7745

NPI assigned

Feb 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edwin Joseph Carey, MD

Title

President

Phone

(815) 786-2101

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992777171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W PLEASANT AVE",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481050",
            "telephone_number": "815-786-2101",
            "fax_number": "815-786-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W PLEASANT AVE",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481050",
            "telephone_number": "815-786-2101",
            "fax_number": "815-786-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-786-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Fedinec, M.D.
• First Impressions by Lerohl & Landers
• Latehesha Fitch, LCPC
• Katie Michelle Fitzgerald, PT
• Kara Flynn, DMD
• Fox Valley Older Adult Services
• Fox Valley Urology S.C.
• Fox Valley Vein Centers, P.C.
• Foxland Respiratory Consultants, S.C.
• Fresenius Medical Care Sandwich, LLC (Fresenius Medical Care Sandwich)

• Surgery Physician in Sandwich, IL
• Providers in Sandwich, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.