Fulcrum Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

72566 Issued in OK

Legal business name

FULCRUM CLINIC LLC

Practice address

1601 SW 89TH St Ste D100
Oklahoma City, OK 73159-6378

Phone

(405) 546-7888

Fax

(844) 518-2784

NPI assigned

Jun 20, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sonya Diane Fergeson

Title

Office Manager and Co-Owner

Phone

(405) 546-7888

Specialties & licenses 1

Addresses

Other names 1

• Fulcrum Health & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Glenndon Fergeson, NP-C

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1497170526
  Medicare reassignment Care Compare group
• Laural R Foster, DNP, APRN, C-FNP

  • Family Nurse Practitioner
  • Norman, OK
  • NPI 1275192254
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1124512322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE D100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596378",
            "telephone_number": "405-546-7888",
            "fax_number": "844-518-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE D100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596378",
            "telephone_number": "405-546-7888",
            "fax_number": "844-518-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULCRUM CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "FERGESON",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER AND CO-OWNER",
        "authorized_official_telephone_number": "405-546-7888"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "72566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulcrum Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fulcrum Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriel Fuentes, MOM
• Leslie Catherine Fuentes, PTA
• Susan Elaine Fugate, PHARM.D.
• Devin Fugett, APRN-C
• Jenna Arin Fulcher, RN
• Shana Fulkerson
• Full Circle Counseling
• Full Function Rehabilitation
• Full Life Hospice, LLC
• Leighann Fullagar, APRN-CNS

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.