Active NPI
Michelle Fulner
- Speech-Language Pathologist
- Indianapolis, IN
National Provider Identifier
1215343090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 46002615A
- Practice address
- 8641 Fawn Lake Cir
Indianapolis, IN 46278-9776 - Phone
- (317) 294-5242
- NPI assigned
- Jul 1, 2014
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 46002615A | IN | Primary |
Addresses
Primary practice location
8641 Fawn Lake Cir
Indianapolis, IN 46278-9776
Mailing address
8641 Fawn Lake Cir
Indianapolis, IN 46278-9776
Phone (317) 294-5242
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46002615A | IN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K1DS Count Therapy, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1215343090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8641 FAWN LAKE CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462789776",
"telephone_number": "317-294-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8641 FAWN LAKE CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462789776",
"telephone_number": "317-294-5242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULNER",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-01",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "46002615A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.