Teri Fullmer, ABO

Primary specialty

OpticianTaxonomy code 156FX1800X

Practice address

7447 W Emerald St Ste 105
Boise, ID 83704-5003

Phone

(208) 322-1642

Fax

(208) 378-4179

NPI assigned

Jul 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1003393653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W EMERALD ST STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045003",
            "telephone_number": "208-322-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W EMERALD ST STE 105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045003",
            "telephone_number": "208-322-1642",
            "fax_number": "208-378-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "TERI",
        "credential": "ABO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABO",
            "identifier": "065186",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Full Circle Health, Inc.
• Full Circle Health, Inc.
• Full Life Care
• Brian D Fuller, CRNA
• Ronald F Fullmer, M.D.
• Barbara Nixon Fultz, COMS
• Darby Fulwider
• Vicki Funaiole
• Functional and Integrative Medicine of Idaho PA
• Functional Medicine of Idaho PC

• Optician in Boise, ID
• Providers in Boise, ID by specialty
• Optician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.