Fountain Healthcare Limited Liability Company
NPI 1902140585ActiveOrganization· Family Medicine· Bloomington, IL
Family Medicine in Bloomington, Illinois, registered in NPPES in November 2012. The authorized official on file is Clyde L. Bass, President.
Overview
| NPI | 1902140585 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 20, 2012 |
| Last updated in NPPES | Sep 21, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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