Jariah Fulson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096004415 Issued in IL

Practice address

2300 S 1St St
Champaign, IL 61820-7661

Phone

(000) 000-0000

NPI assigned

Sep 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134520539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 E MICHIGAN AVE APT 1",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618015061",
            "telephone_number": "402-926-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 1ST ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207661",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULSON",
        "first_name": "JARIAH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096004415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "2255A2300X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittani Fryer
• Berenice Fuentes
• Full Circle Therapy LLC
• Sean Patrick Fullan, M.D.
• Rebekah Lee Fuller Fricke, PSYD
• Byron L Fultz
• August Funk, MD
• Heidi Lynn Gaddey, M.D.
• Emma Gadhiya
• Christopher Gadow, LPC

• Athletic Trainer in Champaign, IL
• Providers in Champaign, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.