Carly Fullerton, MSS ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126001340 Issued in VA

Practice address

201 High St
Farmville, VA 23909-1800

Phone

(434) 395-2965

NPI assigned

Jul 28, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Longwood University

  • Exclusive Provider Organization
  • Farmville, VA
  • NPI 1568897353
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1235547894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MONROE ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239013137",
            "telephone_number": "703-407-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HIGH ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239091800",
            "telephone_number": "434-395-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "CARLY",
        "credential": "MSS ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Franco, APN
• Caitlin Frazier Frank, CCC-SLP
• Janet Lee Frankenberger, PTA
• Freedrew PLLC
• Jason Vaughan French, LPC. LSATP
• Brittany Furfari, M.ED., ED.S., NCSP
• Justin Gates, ATS
• Sara Gaver
• General Business Concerns, Inc.
• Genoa Healthcare LLC

• Athletic Trainer in Farmville, VA
• Providers in Farmville, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.