Kimberley Ann Fulton, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002936 Issued in MI

Practice address

1445 Sheldon Rd Ste 300
Grand Haven, MI 49417-2479

Phone

(616) 296-1500

Fax

(616) 296-1502

NPI assigned

Jul 12, 2005

Last updated

Jul 1, 2024By the provider in NPPES

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 names 1

• Kimberley Ann Herzberg Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfulton1038140@direct.trinity-health.org

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.

• Mercy Physician Network

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1023056744
  Medicare reassignment Care Compare group
• Mercy Physician Network

  dba Fruitport Family Medicine

  • Family Medicine Physician
  • Fruitport, MI
  • NPI 1639502701

  Physician Assistant

  NPD
• Michigan Medical Patient Care

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1073567806
  NPD (past)
• Michigan Medical Patient Care

  • Durable Medical Equipment & Medical Supplies
  • Holland, MI
  • NPI 1871741652
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation
• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Trinity Health Grand Haven Hospital

  • General Acute Care Hospital
  • Grand Haven, MI
  • NPI 1942379284
  Care Compare affiliation

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1043218126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD STE 300",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172479",
            "telephone_number": "616-296-1500",
            "fax_number": "616-296-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD STE 300",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172479",
            "telephone_number": "616-296-1500",
            "fax_number": "616-296-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "KIMBERLEY",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfulton1038140@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "mhpp north ottowa family medicine direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1310 Wisconsin St Ste 103",
            "city": "Grand Haven",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494172472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "HERZBERG",
            "middle_name": "ANN",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christi Rene Fortenbacher, LMT
• Nancy A Foster, RN
• Randi L Foster
• Lindsay Fox, MD
• Jeffrey J Fritz, D.D.S. P.C.
• Kayleigh Gagnon
• Abigail Galombeck
• Cathy Lynn Gamby, M.A., LLPC
• Leah Gantjos, SLP
• Kristin Anne Garling, MA, CCC-SLP

• Physician Assistant in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.