NPIMap

Individual provider Active NPI

Troy M Fulton, MPT

  • Physical Therapist
  • Powell, WY
National Provider Identifier
1013009786
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-526 Issued in WY
Practice address
639 W Coulter Ave
Powell, WY 82435-2527
Phone
(307) 754-9262
Fax
(307) 754-9283
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-526 WY Primary

Addresses

Primary practice location

639 W Coulter Ave
Powell, WY 82435-2527

Mailing address

PO Box 1790
Douglas, WY 82633-1790
Phone (307) 358-9464

Other identifiers 3

IdentifierTypeStateIssuer
192548OtherWAWORK COMP
315266OtherWYBLUE CROSS BLUE SHIELD
115325100MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000758 WY Practitioner - Physical Therapist in Private Practice 1557556347 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Platte Physical Therapy Services IncGroup PAC ID 8921080565, 34 clinicians

Practice addresses (Care Compare)

311 Thelma Dr
Casper, WY 82609-2325
Phone (307) 234-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-526WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fulton & Fulton LLC CurrentSince Jan 1, 2021 Accepting new patients
Northplatte Physical Therpy Services Inc Physical Therapist PastSince Mar 21, 2018 Accepting new patients
William H and Carrie Gottsche Foundation PastSince Nov 1, 2005 Accepting new patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1013009786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331790",
            "telephone_number": "307-358-9464",
            "fax_number": "307-358-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 W COULTER AVE",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352527",
            "telephone_number": "307-754-9262",
            "fax_number": "307-754-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "TROY",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "192548",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "315266",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115325100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.