Active NPI
Kelly Fulgham, RDH
- Dental Hygienist
- Memphis, TN
National Provider Identifier
1073178141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6540
- Practice address
- 1723 Kirby Pkwy
Memphis, TN 38120-4367 - Phone
- (901) 757-9696
- NPI assigned
- May 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6540 | TN | Primary |
Addresses
Primary practice location
1723 Kirby Pkwy
Memphis, TN 38120-4367
Mailing address
3443 Bailey Creek CV S
Collierville, TN 38017-9710
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6540 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556928000000",
"number": "1073178141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3443 BAILEY CREEK CV S",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380179710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1723 KIRBY PKWY",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381204367",
"telephone_number": "901-757-9696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULGHAM",
"first_name": "KELLY",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-04",
"last_updated": "2019-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TN",
"license": "6540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.