ERIC FOUNTAIN (NPI# 1649513250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649513250 |
| Entity Type | Individual |
| Full Name | ERIC FOUNTAIN |
| Practice Address |
520 S Eagle Rd Meridian ID 83642-6351 |
| Practice Telephone | 2083812484 |
| Mailing Telephone | 2083812484 |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
M14950 | ID | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
M14950 | ID | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2301 Erwin Rd, Durham, NC 277054699 | 9196848111 |
| Street Address |
520 S EAGLE RD |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-6351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356348015 | Robert E. Holland Jr. | Family Medicine | 520 S Eagle Rd, Ste 1241, Meridian, ID 83642-6351 | 2005-07-07 |
| 1659984284 | Heather R Zimmerman | Occupational Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-24 |
| 1619587573 | Maria Herbison | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-08-05 |
| 1952927543 | Grayson T Kendall | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-19 |
| 1891310371 | David Joseph Matthews | Respiratory Therapist, Registered | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-06-10 |
| 1356960603 | Rebecca Finder | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-04-15 |
| 1982231023 | Stephen Blake Miltner | Physical Therapist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-26 |
| 1093342834 | Clayton Hawks | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-03-23 |
| 1912547647 | Emily Tyler Getlein Marques | Nurse Practitioner | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2020-01-10 |
| 1184264244 | Jordan Leach | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642 | 2020-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720241201 | Jennifer T Eubanks | Internal Medicine | 1704 23rd Ave Fl 2, Meridian, MS 39301-3103 | 2008-07-06 |
| 1043461817 | Travis G Williams | Internal Medicine | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2008-10-09 |
| 1326140039 | Silvana Z Bucur | Internal Medicine | 520 S Eagle Rd, Lower Level, Meridian, ID 83642-6351 | 2006-09-02 |
| 1265478374 | Stephanie Brooke Hodson | Internal Medicine | 2855 E Magic View Dr, Meridian, ID 83642 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891857512 | Nathan Bradley Adams | Internal Medicine | 2330 Desoto St, Idaho Falls, ID 83404-7570 | 2006-12-16 |
| 1669565669 | A. Richard Miranda | Internal Medicine | 706 N College Rd, Suite A, Twin Falls, ID 83301-5824 | 2006-10-02 |
| 1528075744 | Thomas J Leavitt | Internal Medicine | 284 Buck Run, Sagle, ID 83860 | 2006-08-01 |
| 1669497194 | Dane J Dickson | Internal Medicine | 380 Walker Drive, Rexburg, ID 83440 | 2006-07-13 |
| 1588696538 | Jonathan N Swerdloff | Internal Medicine | 308 E Hawaii Ave, Nampa, ID 83686-6013 | 2006-07-07 |
| 1508809252 | Daniel E Williams | Internal Medicine | 1250 Idaho St, Lewiston, ID 83501-1965 | 2006-06-13 |
| 1871558239 | Michael L Francisco | Internal Medicine | 651 Memorial Dr, Portneuf Cancer Center, Pocatello, ID 83201 | 2006-04-19 |
| 1669462362 | Mountain View Hospital LLC | Internal Medicine | 2325 Coronado St, Idaho Falls, ID 83404-7407 | 2005-10-24 |
| 1952307605 | David W. Ririe | Internal Medicine | 500 S 11th Ave Ste 100, Pocatello, ID 83201-4877 | 2005-06-27 |
| 1477020303 | Maria Teresa Cervantes-fullmer | Internal Medicine | 3245 Channing Way, Idaho Falls, ID 83404-7536 | 2018-10-29 |
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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.