FOUNTAIN MEDICAL ASSOCIATES P C
NPI 1215257837
Family Medicine in Philadelphia, PA

NPI Status: Active since June 04, 2010

Contact Information

22 E MOUNT AIRY AVE
PHILADELPHIA, PA
ZIP 19119
Phone: (215) 924-2440
Fax: (267) 437-2346

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  • Organization
  • Family Medicine
  • CLIA Number: 39D2010485
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-26-2028

About FOUNTAIN MEDICAL ASSOCIATES P C

This page provides the complete NPI Profile along with additional information for Fountain Medical Associates P C, a primary care provider established in Philadelphia, Pennsylvania operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1215257837 assigned on June 2010. The practitioner's primary taxonomy code is 207Q00000X with license number MD428070 (PA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Safiyya S Shabazz Md (Medical Director)

NPI
1215257837
Provider Name
FOUNTAIN MEDICAL ASSOCIATES P C
Entity Type
Organization
Location Address
22 E MOUNT AIRY AVE PHILADELPHIA, PA 19119
Location Phone
(215) 924-2440
Location Fax
(267) 437-2346
Mailing Address
22 E MOUNT AIRY AVE PHILADELPHIA, PA 19119
Mailing Phone
(215) 924-2440
Mailing Fax
(267) 437-2346
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-04-2010
Last Update Date
07-27-2018
Code Navigator

A primary care provider (PCP) like Fountain Medical Associates P C sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 1335 W Tabor Rd Suite 204
    Philadelphia, PA 19141
    (215) 924-2440

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD428070
License State
PA
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. SAFIYYA S SHABAZZ MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(215) 924-2440

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D2010485
Facility Type
Physician Office
Certificate Effective Date
February 27, 2026
Certificate Expiration Date
February 26, 2028
Laboratory Director
DR. SAFIYYA S. SHABAZZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Fountain Medical Associates P C to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215257837, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
8
Unchanged
Pos 9
3
Doubled → 6
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 7 → 14 → 5 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 4 + 5 + 1 + 4 + 8 + 6 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1215257837.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Family Medicine
22 E MOUNT AIRY AVE
PHILADELPHIA, PA 19119

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215257837, enumerated as an "organization" on June 04, 2010.

The provider is located at 22 E MOUNT AIRY AVE PHILADELPHIA, PA 19119 and the phone number is (215) 924-2440.

Family Medicine with taxonomy code 207Q00000X.