Individual provider Active NPI

Zelda R Fulgham, NP

  • Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1215226071
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024169283 Issued in VA
Practice address
110 Kingsley LN
Suite 312
Norfolk, VA 23505-4614
Phone
(757) 354-2885
Fax
(757) 889-5742
NPI assigned
Apr 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024169283 VA Primary

Addresses

Primary practice location

110 Kingsley LN
Suite 312
Norfolk, VA 23505-4614

Mailing address

110 Kingsley LN
Suite 312
Norfolk, VA 23505-4614
Phone (757) 354-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000103 VA Practitioner - Nurse Practitioner 7810171972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1215226071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 312",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-354-2885",
            "fax_number": "757-889-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 312",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-354-2885",
            "fax_number": "757-889-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULGHAM",
        "first_name": "ZELDA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024169283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.