Gregory Alan Fulling, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00007816 Issued in WA

Practice address

2142 W Railroad Ave
Suite a
Shelton, WA 98584-7813

Phone

(360) 426-0175

Fax

(360) 432-2193

NPI assigned

Feb 14, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Total Health Corporation

  dba Total Health Physical Therapy

  • Orthopedic Physical Therapist
  • Shelton, WA
  • NPI 1730242884
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1235307000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 W RAILROAD AVE",
            "address_2": "SUITE A",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985847813",
            "telephone_number": "360-426-0175",
            "fax_number": "360-432-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 W RAILROAD AVE",
            "address_2": "SUITE A",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985847813",
            "telephone_number": "360-426-0175",
            "fax_number": "360-432-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLING",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8347130",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynette Rachelle Frantzen, PHD, LMHC,LPC-S, NCC
• Fred Meyer Pharmacy
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Suzanna Louise Fuentes, LMP
• Sarah Fulkerson
• Joy Fulling
• Sandra Jean Gaddis
• Julianne Gale, MA, MAT, AAC, CPC
• Adam Keenan Gamble
• Carol S Gardner, LMP

• Physical Therapist in Shelton, WA
• Providers in Shelton, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.