GREGORY TODD FOUNTAIN (NPI# 1366456964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366456964 |
| Entity Type | Individual |
| Full Name | GREGORY TODD FOUNTAIN |
| Credential | MD |
| Practice Address |
766 Walther Rd Suite 100 Lawrenceville GA 30046-8764 |
| Mailing Address |
766 Walther Road Suite 100 Lawrenceville GA 30046 |
| Practice Telephone | 6789858001 |
| Mailing Telephone | 6789858001 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2010-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 034593 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | WELLCARE | 314606 | 01 |
| GA | 00509594E | 05 | |
| GA | AMERIGROUP | 10045970 | 01 |
| Street Address |
766 WALTHER RD SUITE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206477 | Michael A. Lipsitt | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2005-09-21 |
| 1285013458 | Katherine Mary Siedor | Physician Assistant | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2015-05-21 |
| 1699166173 | Gladys Orwenyo | Nurse Practitioner | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2015-02-05 |
| 1851630925 | Tiffany Kay Lanford | Nurse Practitioner | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2013-02-08 |
| 1679818991 | Gwinnett Heart Specialists LLC | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2012-11-28 |
| 1356507115 | Ajaz L Chaudhry | Otolaryngology | 766 Walther Rd, Suite 300, Lawrenceville, GA 30046-8764 | 2008-07-31 |
| 1790948578 | Atlanta Gwinnett Obgyn Associates PC | Obstetrics & Gynecology | 766 Walther Rd, Suite 100, Lawrenceville, GA 30045-8726 | 2008-07-02 |
| 1619157989 | Atlanta Gwinnett Women's Specialists | Obstetrics & Gynecology | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8765 | 2007-11-05 |
| 1427199546 | Marcus Ceri Sims | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2007-02-09 |
| 1336107978 | Lemuel G Villanueva | Obstetrics & Gynecology | 766 Walther Rd, Suite 200, Lawrenceville, GA 30046-8765 | 2006-05-03 |
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| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598264681 | Amy Patel | Obstetrics & Gynecology | 123 Franklin Corner Rd Ste 214, Lawrenceville, NJ 08648-2526 | 2018-02-05 |
| 1821316571 | Melissa O'connor Iyoyo | Obstetrics & Gynecology | 500 Medical Center Blvd Ste 250, Lawrenceville, GA 30046-3402 | 2010-05-05 |
| 1255573952 | Marc Andre Jean-gilles | Obstetrics & Gynecology | 601 Professional Dr Ste 370, Lawrenceville, GA 30046-7670 | 2009-03-27 |
| 1578714853 | Thomas C. Tsai M.d. Pa | Obstetrics & Gynecology | 123 Franklin Corner Rd. Suite 106, Lawrenceville, NJ 08648 | 2008-10-06 |
| 1508040353 | Rebecca Lynn Williams | Obstetrics & Gynecology | 761 Old Norcross Road, Lawrenceville, GA 30046-4317 | 2007-12-28 |
| 1558413880 | John Thomas Hydrick | Obstetrics & Gynecology | 761 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2007-01-17 |
| 1528147931 | Azubuike Levi Ezeife | Obstetrics & Gynecology | 2025 Princeton Ave, Lawrenceville, NJ 08648-4323 | 2006-11-04 |
| 1598845653 | Roopali Bhattacharjee | Obstetrics & Gynecology | 638 Lawrence Road, Lawrenceville, NJ 08648 | 2006-10-16 |
| 1376638502 | Kerry L Griffin | Obstetrics & Gynecology | 1389 Legrand Cir, Lawrenceville, GA 30043-8193 | 2006-10-04 |
| 1730287012 | Lynn Ellen Zahner | Obstetrics & Gynecology | 337 W Pike St, Suite A, Lawrenceville, GA 30046-4843 | 2006-09-20 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.