Kelly Fulp, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17390 Issued in MD

Practice address

701 Revolution St
Havre de Grace, MD 21078-3321

Phone

(410) 939-4334

NPI assigned

Jun 25, 2006

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

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smith and Prothero Physical Therapy LLCGroup PAC ID 9335155860, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Smith & Prothero Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Havre de Grace, MD
  • NPI 1942200621
  Medicare reassignment Care Compare group NPD
• Smith & Prothero Physical Therapy LLC

  • Occupational Therapist
  • Havre de Grace, MD
  • NPI 1942844832
  NPD
• Fine, Bryant & Wah, Inc.

  • Physical Therapy Clinic/Center
  • Baltimore, MD
  • NPI 1821606583

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023044302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 AMBLESIDE LN",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210011849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783321",
            "telephone_number": "410-939-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULP",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fridberg Associates, P.C.
• Marianne Fotiadis Fridberg, M.D.
• Herbert Brett Friedman, D.D.S.
• Joseph M. Fritz, D.D.S.
• Judy Fuhrmann
• Sandra Fuqua
• Isabel Cristina Furches, MASTER IN SPECIAL ED
• Ojoma Beauty Gabriel, DNP
• Dominic Robert Gasdia
• Mercia Gee, LMSW

• Physical Therapist in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.