FOUNTAIN FAMILY MEDICINE, PA
NPI 1124228119
Family Medicine in Jacksonville, FL

Q: What is Fountain Family Medicine, PA's NPI number?

The NPI number for Fountain Family Medicine, PA is 1124228119. It was assigned to this organization in the NPPES registry on July 19, 2007.

Q: What is Fountain Family Medicine, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since July 19, 2007

11701-32 SAN JOSE BOULEVARD, SUITE 103, JACKSONVILLE, FL 32223(904) 262-9075 Get Directions Write a Review

NPPES record last updated: August 28, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fountain Family Medicine, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOUNTAIN FAMILY MEDICINE, PA (NPI 1124228119) is a healthcare organization registered as a family medicine in Jacksonville, Florida and active in the NPI registry since July 2007. The organization lists Leanne Macdonald, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1124228119

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameFOUNTAIN FAMILY MEDICINE, PA

Location Address11701-32 SAN JOSE BOULEVARD, SUITE 103Jacksonville, FL 32223

Mailing Address11701-32 San Jose, Suite 103Jacksonville, FL 32223 · (904) 262-9075

Phone(904) 262-9075

Organization SubpartNo

Authorized OfficialLeanne MacdonaldOffice Manager · (904) 262-9075

Enumeration DateJuly 19, 2007

Last NPPES UpdateAugust 28, 2012

✔ NPI 1124228119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

11701-32 SAN JOSE BOULEVARD, Jacksonville, FL 32223

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Other Identifiers 1

Medicare PINK8630FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fountain Family Medicine, PA's NPI number?

The NPI number for Fountain Family Medicine, PA is 1124228119. It was assigned to this organization in the NPPES registry on July 19, 2007.

Where is Fountain Family Medicine, PA located?

Fountain Family Medicine, PA is located at 11701-32 San Jose Boulevard Suite 103, Jacksonville, FL 32223. The listed phone number is (904) 262-9075.

What is Fountain Family Medicine, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Fountain Family Medicine, PA was last updated on August 28, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.