Kevin L. Fulford, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A66474 Issued in CA

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Phone

(619) 704-4966

NPI assigned

Oct 20, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, WY, CO3 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 3

Specialty

Obstetrics/Gynecology

Education

Loma Linda University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obhg Colorado PCGroup PAC ID 2365601226, 8 clinicians

Banner Hospital Based Physicians Colorado LLCGroup PAC ID 6800031386, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfulford181926@direct.llu.edu

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.

• Banner Hospital Based Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1154679637
  Medicare reassignment Care Compare group NPD
• Obhg Colorado, P.C.

  • Obstetrics & Gynecology Physician
  • Colorado Springs, CO
  • NPI 1104116896
  Medicare reassignment Care Compare group NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1073899134
  Medicare reassignment NPD
• Casper Obstetrical and Gynecological Associates PC

  • Obstetrics & Gynecology Physician
  • Casper, WY
  • NPI 1134272917
  Medicare reassignment NPD
• North Colorado Family Medicine

  • Primary Care Clinic/Center
  • Greeley, CO
  • NPI 1083642680
  Medicare reassignment NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Obhg Wyoming PC

  • Obstetrics & Gynecology Physician
  • Casper, WY
  • NPI 1346055068
  Medicare reassignment NPD
• Sterling Regional Medcenter

  • General Acute Care Hospital
  • Sterling, CO
  • NPI 1942238555
  Medicare reassignment NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Torrington, WY
  • NPI 1215375688
  NPD
• Banner Hospital Based Physicians Colorado LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1376304758
  NPD
• Sterling Regional Medcenter

  • Rural Health Clinic/Center
  • Sterling, CO
  • NPI 1225549389
  NPD
• East Morgan County Hospital

  • Critical Access Hospital
  • Brush, CO
  • NPI 1699708743
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1063594612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MURRAY DR",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204113",
            "telephone_number": "423-552-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-704-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371303837",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULFORD",
        "first_name": "KEVIN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A66474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3861990",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Eugene Friedel, M.D.
• Theodore E Friedman, LCSW
• Yangheng Fu, M.D.
• Ana Fuentes Calderon
• Rhea W Fugal, L.C.S.W.
• Gary R. Funk, O.D.
• Alexandra Furukawa, MA, CCC-SLP
• Eda Fushman, LMFT
• G O M G a Medical Partnership
• Lisa Lew Gabhart, M.D.

• Obstetrics & Gynecology Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.