NPIMap

Organization Active NPI

Fuller Rehabilitation and Consulting Services Inc.

  • Customized Equipment (DME)
  • Fort Thomas, KY
National Provider Identifier
1083711204
Registry record updated Oct 23, 2009
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.
Practice address
90 Alexandria Pike
Suite 10
Fort Thomas, KY 41075-4102
Phone
(859) 442-5191
Fax
(859) 442-5473
NPI assigned
Sep 20, 2006
Organization subpart
Yes
Parent organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2009

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
Customized Equipment (DME) 332BC3200X KY Primary

Addresses

Primary practice location

90 Alexandria Pike
Suite 10
Fort Thomas, KY 41075-4102

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
2552910MedicaidOH
200482310AMedicaidIN
0952950009OtherKYMEDICARE ID-TYPE UNSPECIFIED
90001918MedicaidKY

Other names 1

  • Fuller Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fuller Rehabilitation and Consulting Services Inc6 organizations share this tax ID, including this one
Part of
Fuller Rehabilitation and Consulting Services Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

90 Alexandria Pike
Ste 10
Fort Thomas, KY 41075
Phone (859) 442-5191

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1083711204",
    "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": "90 ALEXANDRIA PIKE",
            "address_2": "SUITE 10",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410754102",
            "telephone_number": "859-442-5191",
            "fax_number": "859-442-5473"
        }
    ],
    "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": "2006-09-20",
        "last_updated": "2009-10-23",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2552910",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200482310A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "0952950009",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90001918",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuller Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.