Fulton County Health Department

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

FULTON COUNTY HEALTH DEPARTMENT

Doing business as

Fulton County Health Department

Practice address

700 East Oak Street
Canton, IL 61520

Phone

(309) 647-1134

Fax

(309) 647-9545

NPI assigned

Dec 21, 2005

Last updated

Apr 22, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

FULTON COUNTYAs reported in NPPES

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

Authorized official

Name

Mr. Damon Scott Roberson

Title

Administrator

Phone

(309) 647-1134

Specialties & licenses 2

Addresses

Other names 1

• Fulton County Health Department Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Fulton County HLTH Dept

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Bankert, APN

  • Women's Health Nurse Practitioner
  • Canton, IL
  • NPI 1275662157
  NPD (past)
• Graciela Grammer, DDS

  • Dentist
  • Canton, IL
  • NPI 1982829420
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1245216241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 EAST OAK STREET",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "61520",
            "telephone_number": "309-647-1134",
            "fax_number": "309-647-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 EAST OAK STREET",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "61520",
            "telephone_number": "309-647-1134",
            "fax_number": "309-647-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FULTON COUNTY",
        "enumeration_date": "2005-12-21",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-647-1134",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edrick Jordan Ferguson, M.D.
• Jessica Fink, MS, RD, LDN
• Johnes Marcera Flores, PT
• Justin Freeman, PHARM. D
• Fulton County Emergency Medical Association, Inc.
• Fulton County Rehabilitation Center Inc.
• Kacy Garrard
• Nathan W Gates, MA
• Gayon High Performance Chiropractic & Rehab, Inc
• Ruben Gayon, D.C.

• State or Local Public Health Clinic/Center in Canton, IL
• Providers in Canton, IL by specialty
• State or Local Public Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.