Organization Active NPI

Fulton Chiropractic P a

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1245393883
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 6762 Issued in FL
Legal business name
FULTON CHIROPRACTIC P A
Practice address
8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858
Phone
(239) 275-0770
Fax
(239) 275-5770
NPI assigned
Dec 18, 2006
Last updated
Sep 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Dr. Charles L Fulton, D.C.NPI 1689630998
Title
President
Phone
(239) 275-0770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 6762 FL Primary

Addresses

Primary practice location

8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858

Mailing address

8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858
Phone (239) 275-0770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070125000303 FL Part B Supplier - Clinic/Group Practice 2062413511 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

8841 College Pkwy
Fort Myers, FL 33919

8841 College Pkwy
Ste 102
Fort Myers, FL 33919
Phone (239) 275-0770

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1245393883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8841 COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194858",
            "telephone_number": "239-275-0770",
            "fax_number": "239-275-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8841 COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194858",
            "telephone_number": "239-275-0770",
            "fax_number": "239-275-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON CHIROPRACTIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-275-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 6762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.