Michael Paul Fullenkamp, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2005015807 Issued in MO

Practice address

1 Barnes Jewish Hospital Plaza
St. Louis, MO 63110

Phone

(314) 294-0446

NPI assigned

Oct 5, 2006

Sex

Male

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 IA, NE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

University of Nebraska College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  Medicare reassignment NPD
• New Century Physicians of Iowa PC

  • Emergency Medicine Physician
  • Council Bluffs, IA
  • NPI 1548269301
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1013916600
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Papillion, NE
  • NPI 1063411833
  NPD

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

• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1053408864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 N TAYLOR AVE APT 1W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLAZA",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-294-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLENKAMP",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2005015807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Fulgham
• Madelyn Fulkerson, PT
• Full Circle Home Health Services LLC
• Full Circle Rehab LLC
• Full Potential Residential Services, LLC
• Kim A. Fuller-Barnes
• Brian Matthew Fuller, MD
• Dennis Paul Fuller, PHD CCC SLP
• Emily Fuller
• Marinda Jean Fuller

• Emergency Medicine Physician in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.