Individual provider Active NPI

Terri Fulton, SLP

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1053395087
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL000835 L Issued in PA
Practice address
29 N Academy St
Greenville, SC 29601-2629
Phone
(643) 311-4008
Fax
(864) 331-1416
NPI assigned
Dec 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X SL000835 L PA
Speech-Language Pathologist 235Z00000X SL000835 L PA Primary

Addresses

Primary practice location

29 N Academy St
Greenville, SC 29601-2629

Mailing address

29 N Academy St
Greenville, SC 29601-2629
Phone (643) 311-4008

Other practice location 1

851 Commerce Blvd
Suite 107
Dickson City, PA 18519-1677
Phone (570) 489-5561

Other identifiers 6

IdentifierTypeStateIssuer
1354279OtherPAHIGHMARK
7721306OtherPAAETNA HMO
819174OtherPAFIRST PRIORITY/BC/BS
001862010004MedicaidPA
2653150OtherPAAETNA HMO
163616OtherPAMEDPLUS

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

LicenseStateTypeSpecialty
SL000835 LPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1053395087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N ACADEMY ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012629",
            "telephone_number": "643-311-4008",
            "fax_number": "864-331-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N ACADEMY ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012629",
            "telephone_number": "643-311-4008",
            "fax_number": "864-331-1416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 Commerce Blvd",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Dickson City",
            "state": "PA",
            "postal_code": "185191677",
            "country_code": "US",
            "telephone_number": "570-489-5561",
            "fax_number": "570-489-5563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTON",
        "first_name": "TERRI",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "PA",
            "license": "SL000835 L",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL000835 L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1354279",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "7721306",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY/BC/BS",
            "identifier": "819174",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001862010004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2653150",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDPLUS",
            "identifier": "163616",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.