Organization Active NPI

Michael D. Fulford, PA

  • Optometrist
  • Aiken, SC
National Provider Identifier
1154489573
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
517 Issued in SC
Legal business name
MICHAEL D. FULFORD, PA
Practice address
304 Laurens St NW
Aiken, SC 29801-3997
Phone
(803) 649-9561
Fax
(803) 649-2664
NPI assigned
Dec 5, 2006
Last updated
May 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
Dr. Michael Dennis Fulford, ODNPI 1093734469
Title
President
Phone
(803) 649-9561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 517 SC Primary

Addresses

Primary practice location

304 Laurens St NW
Aiken, SC 29801-3997

Mailing address

304 Laurens St NW
Aiken, SC 29801-3997
Phone (803) 649-9561

National Provider Directory

National Provider Directory

Locations

304 Laurens St NW
Aiken, SC 29801
Phone (803) 649-9561

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1154489573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 LAURENS ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013997",
            "telephone_number": "803-649-9561",
            "fax_number": "803-649-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 LAURENS ST NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013997",
            "telephone_number": "803-649-9561",
            "fax_number": "803-649-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. FULFORD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "FULFORD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-649-9561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.