Larry Elmer Fultz, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06248 Issued in MD

Practice address

5024 Campbell Blvd
Suite H
Baltimore, MD 21236

Phone

(410) 931-9280

NPI assigned

Mar 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Marsh Psychiatric Associates, LLCGroup PAC ID 3072681105, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• White Marsh Psychiatric Associates, LLC

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1043466147

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1164693172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ALABAMA RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044308",
            "telephone_number": "410-823-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 CAMPBELL BLVD",
            "address_2": "SUITE H",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21236",
            "telephone_number": "410-931-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "LARRY",
        "middle_name": "ELMER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Fulton, M.D.
• Kathleen Fulton, PA-C
• Marshall Haven Fulton
• Monique Fulton
• Rosalyn Contina Fulton, LCPC
• Fun Time Therapy LLC
• Funado Care Services Inc
• Sanaa Funches
• Amber Funderburk, BSN, RN
• Ashley Funderburk, LCPC

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.