FOUNTAIN VALLEY HEALTH CARE LLC
NPI 1275272924
Clinic/Center - Primary Care in Fountain, CO
About Fountain Valley Health Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FOUNTAIN VALLEY HEALTH CARE LLC (NPI 1275272924) is a healthcare organization registered as a primary care in Fountain, Colorado and active in the NPI registry since June 2022. The organization lists Jacquita Jordan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Identifiers 1
Group Practice 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 06D2267080
Fountain Valley Healthcare · Fountain, COOther Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FOUNTAIN, CO 80817
FOUNTAIN, CO 80817
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 Valley Health Care LLC's NPI number?
The NPI number for Fountain Valley Health Care LLC is 1275272924. It was assigned to this organization in the NPPES registry on June 1, 2022.
Where is Fountain Valley Health Care LLC located?
Fountain Valley Health Care LLC is located at 5115 Fontaine Blvd, Fountain, CO 80817. The listed phone number is (719) 271-2887.
What is Fountain Valley Health Care LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
When was this NPI record last updated?
The NPPES record for Fountain Valley Health Care LLC was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days 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.
# Fountain Valley Health Care Llc · NPI 1275272924
Primary Care organization in Fountain, Colorado. Organization record, active in the CMS NPPES registry since June 1, 2022.
## Identity
- **NPI:** 1275272924 (Entity type: Organization)
- **Enumerated:** June 1, 2022
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jacquita Jordan, OWNER
## Practice location
- **Address:** 5115 FONTAINE BLVD, Fountain, CO 80817-1061
- **Phone:** (719) 271-2887
## Record status
- **NPPES last updated:** June 26, 2026
- **Other identifiers:** Medicaid 9000224288 (CO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1275272924) · Data from the CMS NPPES public registry.