Kylie Jeannine Fullner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009346 Issued in GA

Practice address

325 N Saint Paul St
Suite 4200
Dallas, TX 75201-3801

Phone

(866) 953-0011

Fax

(866) 953-0012

NPI assigned

Jul 8, 2008

Last updated

Aug 18, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1245493329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1415",
            "city": "MADISON",
            "state": "NE",
            "postal_code": "687481415",
            "telephone_number": "402-310-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST",
            "address_2": "SUITE 4200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013801",
            "telephone_number": "866-953-0011",
            "fax_number": "866-953-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLNER",
        "first_name": "KYLIE",
        "middle_name": "JEANNINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009346",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1103936",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2736",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1186306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Lachine Fuller, MBA, QMHP-CS, PSS
• Stephanie Renee Fuller, MS, FNP-C
• Timothy Fuller, MD
• Timothy Brandon Fuller, PRIMARY BENEFICIARY
• Fulllife Medical Supply
• James Mark Fulmer, MD
• Rita Fulmer, FNPC
• Debra L Fulton, LPC
• Haley Hartwick Fulton
• June E Fulton, MSW LCSW PHD

• Physical Therapist in Dallas, TX
• Providers in Dallas, 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 18, 2009; 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.