Fountain Healthcare Limited Liability Company
NPI 1902140585 · Family Medicine Physician · Bloomington, IL
Fountain Healthcare Limited Liability Company is a Family Medicine Physician organization in Bloomington, IL (NPI 1902140585).
Provider details
- NPI number
- 1902140585
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Clyde Bass, President(415) 754-3379
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
Mailing address
Other names (DBA / former)
- Doing business as
- Liferx
Registry dates
- Enumerated
- 2012-11-20
- Last updated
- 2016-09-21
Frequently asked questions
- What is Fountain Healthcare Limited Liability Company's NPI number?
- Fountain Healthcare Limited Liability Company's National Provider Identifier (NPI) is 1902140585, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fountain Healthcare Limited Liability Company?
- Fountain Healthcare Limited Liability Company is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Fountain Healthcare Limited Liability Company located?
- Fountain Healthcare Limited Liability Company's practice location on file with NPPES is 2412 E Washington St Ste 6, Bloomington, IL 61704-4497.
- What is Fountain Healthcare Limited Liability Company's phone number?
- The practice phone number listed in the NPPES registry for Fountain Healthcare Limited Liability Company is (309) 585-2116.
- Who is the authorized official for Fountain Healthcare Limited Liability Company?
- The authorized official listed on Fountain Healthcare Limited Liability Company's NPPES record is Clyde Bass, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fountain Healthcare Limited Liability Company's NPI active?
- Yes — Fountain Healthcare Limited Liability Company's NPI (1902140585) is active in the NPPES registry as of the last update on 2016-09-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.