Active NPI
Elodie Fuller, PT, DPT
- Physical Therapist
- Klamath Falls, OR
National Provider Identifier
1194630582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62648
- Practice address
- 2200 Bryant Williams Dr
Klamath Falls, OR 97601-1120 - Phone
- (541) 274-6406
- NPI assigned
- Aug 18, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62648 | OR | Primary |
Addresses
Primary practice location
2200 Bryant Williams Dr
Klamath Falls, OR 97601-1120
Mailing address
869 Westview Dr
Klamath Falls, OR 97603-7160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1194630582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "869 WESTVIEW DR",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976037160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BRYANT WILLIAMS DR",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011120",
"telephone_number": "541-274-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "ELODIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-18",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.