Organization Active NPI

Fuller Rehabilitation and Consulting Services Inc.

Doing business as Fuller Rehabilitation

  • Customized Equipment (DME)
  • Ringgold, GA
National Provider Identifier
1063445526
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Doing business as
Fuller Rehabilitation
Practice address
529 Rollins Industrial Blvd
Ringgold, GA 30736-2872
Phone
(706) 965-6131
Fax
(706) 965-3801
NPI assigned
Jul 8, 2006
Last updated
May 20, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Authorized official

Name
Mr. Carter D. Fuller
Title
President, Ceo
Phone
(706) 965-0352

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X GA
Customized Equipment (DME) 332BC3200X GA Primary

Addresses

Primary practice location

529 Rollins Industrial Blvd
Ringgold, GA 30736-2872

Mailing address

PO Box 615
Ringgold, GA 30736-0615
Phone (706) 965-6131

Other identifiers 3

IdentifierTypeStateIssuer
4581852MedicaidTN
1063445526MedicaidAL
000660074AMedicaidGA

Other names 1

  • Fuller Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Part of
Fuller Rehabilitation and Consulting Services Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1063445526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 615",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307360615",
            "telephone_number": "706-965-6131",
            "fax_number": "706-413-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 ROLLINS INDUSTRIAL BLVD",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362872",
            "telephone_number": "706-965-6131",
            "fax_number": "706-965-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER REHABILITATION AND CONSULTING SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FULLER REHABILITATION AND CONSULTING SERVICES INC.",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "CARTER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "706-965-0352",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4581852",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063445526",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000660074A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuller Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.