Individual provider Active NPI

Christi L Fulford

  • Phlebotomy Technician
  • Carrollton, GA
National Provider Identifier
1063263085
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
24068548 Issued in GA
Practice address
817 Bankhead Hwy Ste B
Carrollton, GA 30117-1919
Phone
(678) 664-1833
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X 24068548 GA Primary

Addresses

Primary practice location

817 Bankhead Hwy Ste B
Carrollton, GA 30117-1919

Mailing address

817 Bankhead Hwy Ste B
Carrollton, GA 30117-1919
Phone (678) 664-1833

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
24068548GAMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1063263085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BANKHEAD HWY STE B",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301171919",
            "telephone_number": "678-664-1833",
            "fax_number": "866-993-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 BANKHEAD HWY STE B",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301171919",
            "telephone_number": "678-664-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULFORD",
        "first_name": "CHRISTI",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "GA",
            "license": "24068548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.