Andrea Marie Fullerton, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

046772 Issued in KS

Practice address

1515 S Clifton
Ste 400
Wichita, KS 67208

Phone

(316) 636-1550

Fax

(316) 689-9769

NPI assigned

Jun 15, 2007

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in KS

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 1

Specialty

Obstetrics/Gynecology

Education

Sanford School of Medicine of University of South Dakota, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

Procedures performed for Medicare patients

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.

• Ascension Medical Group Via Christi, PA

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1063453991
  Medicare reassignment Care Compare group NPD
• Ascension Medical Group Via Christi, PA

  • Rural Health Clinic/Center
  • Wellington, KS
  • NPI 1538773569
  NPD
• Ascension Medical Group Via Christi, PA

  dba Ascension Via Christi Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wichita, KS
  • NPI 1073523452
  NPD (past)
• Ascension Via Christi Hospitals Wichita Inc.

  • General Acute Care Hospital
  • Wichita, KS
  • NPI 1154314789
  NPD (past)

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

• Ascension Via Christi Hospitals Wichita Inc.

  • General Acute Care Hospital
  • Wichita, KS
  • NPI 1154314789
  Care Compare affiliation

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1063617587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S CLIFTON",
            "address_2": "STE 400",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "316-636-1550",
            "fax_number": "316-689-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "046772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK MEDICAID",
            "identifier": "200429620A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200865920A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Colleen Fulford, LSCSW
• Erin M Fulghum, PT
• Kathryn M Fulghum, APRN
• Full Circle Chiropractic LLC
• Lesa Fuller
• Ryan Christopher Fullmer, DO
• Fully Connected Counseling LLC
• Morgan Whitney Fulmer
• Nancy A Fultz, LSCSW
• Sarah Fultz

• Obstetrics & Gynecology Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Obstetrics & Gynecology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.