Active NPI
Terri Fulton, SLP
- Speech-Language Pathologist
- Greenville, SC
National Provider Identifier
1053395087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL000835 L
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1354279 | Other | PA | HIGHMARK |
| 7721306 | Other | PA | AETNA HMO |
| 819174 | Other | PA | FIRST PRIORITY/BC/BS |
| 001862010004 | Medicaid | PA | |
| 2653150 | Other | PA | AETNA HMO |
| 163616 | Other | PA | MEDPLUS |
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 |
|---|---|---|---|
| SL000835 L | PA | MD | Speech-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.