OrganizationActive
Fountain of Youth, LLC
NPI 1316205115 · Clinic/Center · Terre Haute, IN
Fountain of Youth, LLC is a Clinic/Center organization in Terre Haute, IN (NPI 1316205115).
Provider details
- NPI number
- 1316205115
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Sherri Jernberg, Owner/Operator(812) 239-4090
- License
- 71002624A (IN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8810 Wabash Ave
Terre Haute, IN 47803-3908
Phone: (812) 239-4090
Street-level locationGet directions
Mailing address
8810 Wabash Ave
Terre Haute, IN 47803-3908
Other names (DBA / former)
- Doing business as
- Seelyville Family Practice
Registry dates
- Enumerated
- 2012-04-30
- Last updated
- 2012-04-30
Frequently asked questions
- What is Fountain of Youth, LLC's NPI number?
- Fountain of Youth, LLC's National Provider Identifier (NPI) is 1316205115, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fountain of Youth, LLC?
- Fountain of Youth, LLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Fountain of Youth, LLC located?
- Fountain of Youth, LLC's practice location on file with NPPES is 8810 Wabash Ave, Terre Haute, IN 47803-3908.
- What is Fountain of Youth, LLC's phone number?
- The practice phone number listed in the NPPES registry for Fountain of Youth, LLC is (812) 239-4090.
- Who is the authorized official for Fountain of Youth, LLC?
- The authorized official listed on Fountain of Youth, LLC's NPPES record is Sherri Jernberg, Owner/Operator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fountain of Youth, LLC's NPI active?
- Yes — Fountain of Youth, LLC's NPI (1316205115) is active in the NPPES registry as of the last update on 2012-04-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.