Carole Fuller-Edmonds, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4276 AL Issued in AL

Practice address

201 N Main St
Suite J
Boaz, AL 35957-1601

Phone

(256) 593-0035

Fax

(256) 593-9101

NPI assigned

Feb 27, 2006

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Carole Fuller Edmonds, DMD

  • Dentist
  • Boaz, AL
  • NPI 1154783280
  NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1144296302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "PISGAH",
            "state": "AL",
            "postal_code": "357650309",
            "telephone_number": "256-593-0035",
            "fax_number": "256-593-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAIN ST",
            "address_2": "SUITE J",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359571601",
            "telephone_number": "256-593-0035",
            "fax_number": "256-593-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER-EDMONDS",
        "first_name": "CAROLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "4276",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4276 AL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-DENTAL",
            "identifier": "135433",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - DENTAL",
            "identifier": "51090809",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009006500",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA USA",
            "identifier": "630980899",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDOA - DENTAL",
            "identifier": "887635",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Erin Evans, DO
• Gideon P Ewing, MD
• Family Dentistry
• Jace Cooper Ferguson, ATC
• Andrew Grout Finlay Jr., MD
• Kayla Stapp Gable, FNP
• Galloway Chiropractic Center, LLC
• James Eric Galloway, D.C.
• Georgia Gamble
• Enrico D Gaspar, M.D.

• All providers in Boaz, AL
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.