Ms Caroline Gordy Fountain, PHYSICAL THERAPIST is a medicare enrolled "Physical Therapist" provider in Raymond, Mississippi. Her current practice location is
13010 Hwy 18, Raymond, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 857-2229.
Ms Caroline Gordy Fountain is licensed to practice in Mississippi (license number PT7134) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043987647.
Healthcare Provider's Profile
Full Name | Ms Caroline Gordy Fountain |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 13010 Hwy 18, Raymond, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043987647
- Provider Enumeration Date: 08/23/2021
- Last Update Date: 10/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 1355747189
- Enrollment ID: I20250228001584
Medical Identifiers
Medical identifiers for Ms Caroline Gordy Fountain such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043987647 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | PT7134 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Caroline Gordy Fountain allows following entities to bill medicare on her behalf.
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1881271302 PECOS PAC ID: 5193036432 Enrollment ID: O20160126001261 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Caroline Gordy Fountain is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Caroline Gordy Fountain, PHYSICAL THERAPIST 921 West Beacon Street, Philadelphia, MS 39350 Ph: (601) 650-0002 | Ms Caroline Gordy Fountain, PHYSICAL THERAPIST 13010 Hwy 18, Raymond, MS 39154-9526 Ph: (601) 857-2229 |
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