Jamie Lynn Fulfer, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036120266 Issued in IL

Practice address

602 W. University Avenue
OB/GYN
Urbana, IL 61801

Phone

(217) 383-3140

Fax

(217) 383-4966

NPI assigned

Oct 10, 2006

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1578821005
  Medicare reassignment NPD
• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1801687728
  NPD
• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Urbana, IL
  • NPI 1952894180
  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1093802001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W. UNIVERSITY AVENUE",
            "address_2": "OB/GYN",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-3140",
            "fax_number": "217-383-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULFER",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036120266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Frazier, CRNA
• Emily Freedman, SLP
• Janice Frerichs, CNP
• Maureen Ellen Frogley, CCC-SLP-L
• Deborah J Frownfelter, NP
• Brett A Fulks, NP
• Shawnda Fuller-Alwes, AUDIOLOGIST
• Martina Gad Gabra, M.D.
• Jordan Taylor Gabriele, DDS
• Mounika Gadiraju, DDS

• Obstetrics & Gynecology Physician in Urbana, IL
• Providers in Urbana, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.