FOUNTAIN ADULT HOME CARE, LLC
NPI 1295191450
Custodial Care Facility - Adult Care Home in Tarboro, NC

NPI Status: Active since January 04, 2016

Contact Information

303 WILLIAM WALSTON LANE
TARBORO, NC
ZIP 27886
Phone: (252) 641-4388
Fax: (252) 641-6412

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 34D2096083
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 05-13-2027

About FOUNTAIN ADULT HOME CARE, LLC

This page provides the complete NPI Profile along with additional information for Fountain Adult Home Care, Llc, a provider established in Tarboro, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1295191450 assigned on January 2016. The practitioner's primary taxonomy code is 311ZA0620X with license number FCL033012 (NC). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mrs. Shirley Walston Mcneil (Owner/administrator)

NPI
1295191450
Provider Name
FOUNTAIN ADULT HOME CARE, LLC
Entity Type
Organization
Location Address
303 WILLIAM WALSTON LANE TARBORO, NC 27886
Location Phone
(252) 641-4388
Location Fax
(252) 641-6412
Mailing Address
303 WILLIAM WALSTON LANE TARBORO, NC 27886
Mailing Phone
(252) 641-4388
Mailing Fax
(252) 641-6412
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-04-2016
Last Update Date
05-10-2016
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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

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
FCL033012
License State
NC
Taxonomy Description
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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

MRS. SHIRLEY WALSTON MCNEIL

Authorized Official Title
OWNER/ADMINISTRATOR
Authorized Official Phone
(252) 641-4388

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
34D2096083
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
May 14, 2025
Certificate Expiration Date
May 13, 2027
Laboratory Director
MICHELLE ALLEN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Fountain Adult Home Care, Llc 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 1295191450, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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
9
Doubled → 18 → 1 + 8
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
4
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
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 9 → 18 → 9 1 → 2 1 → 2 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 8 + 5 + 2 + 9 + 2 + 4 + 1 + 0 + 24 = 60

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

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1295191450.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295191450, enumerated as an "organization" on January 04, 2016.

The provider is located at 303 WILLIAM WALSTON LANE TARBORO, NC 27886 and the phone number is (252) 641-4388.

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.