MICHAEL MCKINLEY FOUNTAIN (FNP-BC) – Family Nurse Practitioner, NPI 1073023115
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MICHAEL MCKINLEY FOUNTAIN (FNP-BC)
1120 INDIAN DR STE C
EASTMAN, GA 310237671
Phone: (478) 374-1778
Fax: (478) 374-1727
Type: Location
79-1019 HAUKAPILA ST
KEALAKEKUA, HI 967507920
Phone: (808) 322-9311
Fax: (478) 296-2801
Type: Mailing
Hillcrest Parkway, Dublin, Laurens County, Georgia, 31021, United States
DUBLIN, GA 310213688
Phone: (478) 296-2800
Fax: (478) 296-2801
Type: Mailing
65-1204 PONO LN
KAMUELA, HI 967437527
Phone: (478) 719-5429
Fax: (478) 296-2801
Type: Mailing
79-7199 MAMALAHOA HWY APT 218
HOLUALOA, HI 967259765
Phone: (478) 719-5429
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190220001854 | I | Nurse Practitioner | GA | TBD |
| I20190819003404 | I | Nurse Practitioner | HI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 119 | 117 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 65 | 65 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 50 | 48 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 14 | 13 | $0 |
Insurance plans in this area (ZIP 31023)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | CA | |
| Emergency Medicine | HI | |
| Emergency Medicine | CE | |
| Emergency Medicine, Internal Medicine | PA | |
| Emergency Medicine | TX | |
| Emergency Medicine | HI | |
| Emergency Medicine | OH | |
| Emergency Medicine | HI | |
| Emergency Medicine | AZ | |
| Family Practice, Emergency Medicine | HI |
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