Active NPI
Adam Thomas Fulkerson, D.C.
- Chiropractor
- Elizabethtown, KY
National Provider Identifier
1134215577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4563
- Practice address
- 1606 N Dixie Hwy
Ste 111
Elizabethtown, KY 42701-5565 - Phone
- (270) 234-8880
- Fax
- (270) 234-1343
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4563 | KY | Primary |
Addresses
Primary practice location
1606 N Dixie Hwy
Ste 111
Elizabethtown, KY 42701-5565
Mailing address
1606 N Dixie Hwy
Ste 111
Elizabethtown, KY 42701-5565
Phone (270) 234-8880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85003002 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1606 N Dixie Ave
Suite 111
Elizabethtown, KY 42701-5572
Phone (270) 234-8880
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Chiropractor
- Elizabethtown, KY
- NPI 1083891428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398902400000",
"number": "1134215577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1606 N DIXIE HWY",
"address_2": "STE 111",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427015565",
"telephone_number": "270-234-8880",
"fax_number": "270-234-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 N DIXIE HWY",
"address_2": "STE 111",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427015565",
"telephone_number": "270-234-8880",
"fax_number": "270-234-1343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULKERSON",
"first_name": "ADAM",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2014-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "4563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85003002",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.