Active NPI
Dawn Marie Fulmer, R.D.
- Pediatric Nutrition Registered Dietitian
- Elkhart, IN
National Provider Identifier
1255591590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 37001283A
- Practice address
- 1201 Bower St
Elkhart, IN 46514-2434 - Phone
- (574) 361-2667
- NPI assigned
- Jun 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 37001283A | IN | Primary |
Addresses
Primary practice location
1201 Bower St
Elkhart, IN 46514-2434
Mailing address
1201 Bower St
Elkhart, IN 46514-2434
Phone (574) 361-2667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37001283A | IN | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1255591590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 BOWER ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142434",
"telephone_number": "574-361-2667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 BOWER ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142434",
"telephone_number": "574-361-2667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULMER",
"first_name": "DAWN",
"middle_name": "MARIE",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "IN",
"license": "37001283A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.