Cory Ryan Fuller, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH7080 Issued in AL

Practice address

410 2ND Ave E
Suite C
Oneonta, AL 35121-1412

Phone

(205) 274-0922

Fax

(205) 274-0924

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

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 AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sparks Physical Therapy IncGroup PAC ID 5597195727, 12 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sparks Physical Therapy Inc

  dba Northeast Orthopedics Physical Therapy

  • Physical Therapy Clinic/Center
  • Rainbow City, AL
  • NPI 1285273748
  Medicare reassignment Care Compare group
• Drayer Physical Therapy-Alabama, LLC

  • Physical Therapist
  • Gardendale, AL
  • NPI 1023440583
  Medicare reassignment NPD
• Drayer Physical Therapy Alabama LLC

  • Physical Therapy Clinic/Center
  • Northport, AL
  • NPI 1417593625
  NPD
• Drayer Physical Therapy-Alabama, LLC

  dba Rehab At Work

  • Physical Therapist
  • Tuscaloosa, AL
  • NPI 1366874869
  NPD

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1053714337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 2ND AVE E",
            "address_2": "SUITE C",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211412",
            "telephone_number": "205-274-0922",
            "fax_number": "205-274-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 2ND AVE E",
            "address_2": "SUITE C",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211412",
            "telephone_number": "205-274-0922",
            "fax_number": "205-274-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CORY",
        "middle_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH7080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Faust, RPH
• Nathan Ashton Foshee, PT, DPT
• Stephanie Fowler, RN
• Ashley Brett Fox, O.D.
• Aubrey Fox, FNP
• Leah Christine Galbreath, FNP
• Leah Shae Ganus, MS CCC-SLP
• Marsha Gilbreath
• Christina Turner Godfrey, FNP
• Hisham H Goreish, MD

• Physical Therapist in Oneonta, AL
• Providers in Oneonta, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.