Active NPI
Patricia A Fults, MDH
- Dental Hygienist
- Port St Joe, FL
National Provider Identifier
1124256201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH5687
- Practice address
- 2475 Garrison Ave
Port St Joe, FL 32456-5265 - Phone
- (850) 227-1276
- Fax
- (850) 227-9101
- NPI assigned
- Jun 26, 2009
- 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 | DH5687 | FL | Primary |
Addresses
Primary practice location
2475 Garrison Ave
Port St Joe, FL 32456-5265
Mailing address
2475 Garrison Ave
Port St Joe, FL 32456-5265
Phone (850) 227-1276
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 |
|---|---|---|---|
| DH5687 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1124256201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2475 GARRISON AVE",
"city": "PORT ST JOE",
"state": "FL",
"postal_code": "324565265",
"telephone_number": "850-227-1276",
"fax_number": "850-227-9101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2475 GARRISON AVE",
"city": "PORT ST JOE",
"state": "FL",
"postal_code": "324565265",
"telephone_number": "850-227-1276",
"fax_number": "850-227-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTS",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "MDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-26",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH5687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Joe, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.