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DR. KELLY DALE FOUNTAIN D.C.
NPI 1548389786
Chiropractor in Port Townsend, WA

Active since March 28, 2007
1330 LAWRENCE ST, PORT TOWNSEND, WA 98368(360) 385-0322(360) 385-5626 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kelly Dale Fountain D.c. NPPES

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

DR. KELLY DALE FOUNTAIN D.C. (NPI 1548389786) is an individual chiropractor in Port Townsend, Washington, licensed in Washington (CH00002812) and active in the NPI registry since March 2007. She is a graduate of Life Chiropractic College - West (1986).

NPPES Registry Identity

NPI1548389786
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. KELLY DALE FOUNTAINCredential: D.C.
Location Address1330 LAWRENCE STPort Townsend, WA 98368-6555
Mailing Address1330 Lawrence StPort Townsend, WA 98368-6555 · (360) 385-0322 · Fax (360) 385-5626
Phone(360) 385-0322
Fax(360) 385-5626
Sole ProprietorYes
Medical School CMSLife Chiropractic College - WestGraduated 1986
Enumeration DateMarch 28, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1548389786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WA · CH00002812
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1330 LAWRENCE ST, Port Townsend, WA 98368
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Other Identifiers 1

Medicare UPINT06657WA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Dale Fountain D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991733602
PECOS Enrollment IDI20050802001257

Medicare Billing Reassignment

Medicare enrollment records show Kelly Fountain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dale Fountain, Dc, Ps
0.5 mi
Chiropractor
2041 E SIMS WAY
Port Townsend, WA 98368
  • Reassigned Medicare billing, Washington enrollment
NPI 1144472036 (360) 379-9284

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MELISSA BETH CARLSON-MICHAELS D.C.
Chiropractor
1330 LAWRENCE ST
PORT TOWNSEND, WA 98368
Jefferson County (360) 385-0322
HEATHER SANDERS LMT
Massage Therapist
1330 LAWRENCE ST
PORT TOWNSEND, WA 98368
Jefferson County (360) 643-3269
CARLSON CHIROPRACTIC CENTER, PC
Chiropractor
1330 LAWRENCE ST
PORT TOWNSEND, WA 98368
Jefferson County (360) 385-0322
DR. JANEL MARIE CARLSON D.C.
Chiropractor
1330 LAWRENCE ST
PORT TOWNSEND, WA 98368
Jefferson County (360) 385-0322
DR. THOMAS WILLIAM KIRBY D.C.
Chiropractor
1330 LAWRENCE ST
PORT TOWNSEND, WA 98368
Jefferson County (360) 385-0322

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 Kelly Fountain's NPI number?

The NPI number for Kelly Fountain is 1548389786. It was assigned to this individual provider in the NPPES registry on March 28, 2007.

Where is Kelly Fountain located?

Kelly Fountain practices at 1330 Lawrence St, Port Townsend, WA 98368. The listed phone number is (360) 385-0322.

What is Kelly Fountain's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kelly Fountain enrolled in Medicare?

Yes. Kelly Fountain is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Fountain's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Fountain reassigns Medicare benefits to Dale Fountain, Dc, Ps (Port Townsend, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Fountain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Fountain was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.