Active NPI
Jody E Fulper
- Pharmacist
- Hernando, MS
National Provider Identifier
1013405059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-12940
- Practice address
- 2600 McIngvale Rd
Hernando, MS 38632-8658 - Phone
- (662) 429-8767
- Fax
- (662) 429-8599
- NPI assigned
- Apr 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-12940 | MS | Primary |
Addresses
Primary practice location
2600 McIngvale Rd
Hernando, MS 38632-8658
Mailing address
2600 McIngvale Rd
Hernando, MS 38632-8658
Phone (662) 429-8767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-12940 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524614400000",
"number": "1013405059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 MCINGVALE RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386328658",
"telephone_number": "662-429-8767",
"fax_number": "662-429-8599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 MCINGVALE RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386328658",
"telephone_number": "662-429-8767",
"fax_number": "662-429-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULPER",
"first_name": "JODY",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-25",
"last_updated": "2018-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-12940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hernando, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.