Individual provider Active NPI

Ashley Megan Fulkerson, DPT

  • Physical Therapist
  • Kent, WA
National Provider Identifier
1275821829
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60226274 Issued in WA
Practice address
13215 SE 240TH St Ste D
Kent, WA 98042-5120
Phone
(253) 631-3026
Fax
(253) 631-3899
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60226274 WA Primary

Addresses

Primary practice location

13215 SE 240TH St Ste D
Kent, WA 98042-5120

Mailing address

PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134

Other names 1

  • Ashley Megan Daniel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110915000862 WA Practitioner - Physical Therapist in Private Practice 4183895543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60226274WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Puget Sound Health and Rehab LLC Physical Therapist CurrentSince Dec 7, 2022 Accepting new patients
Within Pelvic Health PT, PLLC Current Accepting new patients

Locations

13215 SE 240th St
Ste D
Kent, WA 98042
Phone (253) 631-3026

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1275821829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13215 SE 240TH ST STE D",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980425120",
            "telephone_number": "253-631-3026",
            "fax_number": "253-631-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "ASHLEY",
        "middle_name": "MEGAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60226274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "DANIEL",
            "middle_name": "MEGAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.