Mackenzie Fullmer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1396782 Issued in TX

Practice address

5480 FM 423 Ste 2100
Frisco, TX 75036-7914

Phone

(214) 494-4643

NPI assigned

Aug 15, 2024

Sex

Female

Sole proprietor

No

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 TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fit Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Frisco, TX
  • NPI 1194167486
  Medicare reassignment NPD

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1225860570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 FM 423 STE 2100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750367914",
            "telephone_number": "214-494-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 FM 423 STE 2100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750367914",
            "telephone_number": "214-494-4643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 US-377",
            "address_purpose": "LOCATION",
            "city": "Aubrey",
            "state": "TX",
            "postal_code": "76227",
            "country_code": "US",
            "telephone_number": "214-494-4643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "MACKENZIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1396782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domini Fuentes, BCBA
• Victoria Fuentes
• Paul Fuentez Jr., LPC-A
• Trevin M. Fugere, D.C.
• Thomas Brian Fulbrook, LCSW
• Grace Fultang, DNP, PMHNP-BC
• Cierra Fultz, RN
• Lindsey Fultz, D.C
• Joy Teixeira-Lima Fun, DC
• Functional Beginnings, PLLC

• Physical Therapist in Frisco, TX
• Providers in Frisco, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.