NPIMap

Individual provider Active NPI

Kristin Marie Fulkerson, MD

  • Family Medicine Physician
  • MC Cook, NE
National Provider Identifier
1174701239
Registry record updated Jan 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24897 Issued in NE
Practice address
1301 E H St
MC Cook, NE 69001-3482
Phone
(308) 344-4110
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Hospital Association 26 clinicians

Practice addresses (Care Compare)

1301 E H St
MC Cook, NE 69001-3482
Phone (308) 344-2650

Hospital & facility affiliations

  • Angels Care Home Health of McCook Home health agency, McCook, NE, CCN 287106
  • Angels Care Hospice of McCook Hospice, McCook, NE, CCN 281531
  • Community Hospital Hospital, McCook, NE, CCN 281363
  • Great Plains Health Hospital, North Platte, NE, CCN 280065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140724000307 NE Practitioner - Family Practice 6305961905 Reassigns benefits to 2 organizations

All facility ownership & control disclosures 2

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Healthcare and HospiceMcCook, NE, CCN 287106 Home health agency Contracted Managing Employee
Operational/Managerial Control		 Feb 23, 2018
Feb 23, 2018
Community Healthcare and HospiceMcCook, NE, CCN 281531 Hospice Contracted Managing Employee
Operational/Managerial Control		 Feb 23, 2018
Feb 23, 2018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24897NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Association CurrentSince Aug 1, 2014 Accepting new patients
Community Hospital Association Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
Community Hospital Association Current Accepting new patients

Locations

1401 E H St
McCook, NE 69001
Phone (308) 344-4110

1301 E H St
McCook, NE 69001
Phone (308) 344-2650

Interoperability endpoints

  • Direct secure messaging: kristinfulkerson@mccpc.allscriptsdirect.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24897 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

1301 E H St
MC Cook, NE 69001-3482

Mailing address

PO Box 1207
MC Cook, NE 69001-1207
Phone (308) 344-4110

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 19, 2025.

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1174701239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1207",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690011207",
            "telephone_number": "308-344-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E H ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013482",
            "telephone_number": "308-344-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "24897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Cook, NE

Sources for this page

Verify at the official NPI Registry.