Burton Fullmer, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3785956004 Issued in UT

Practice address

5689 S Redwood Rd
Suite 30
Salt Lake City, UT 84123-5447

Phone

(801) 268-1715

Fax

(801) 268-1783

NPI assigned

Oct 3, 2012

Last updated

Oct 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smile Psychiatry and BehavioralGroup PAC ID 4082138904, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smile Psychiatry and Behavioral

  • Psychiatry Physician
  • Draper, UT
  • NPI 1043970262
  Medicare reassignment Care Compare group NPD
• Deborah a Christensen PHD & Associates, Inc

  • Psychologist
  • Draper, UT
  • NPI 1891955936
  Medicare reassignment NPD

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1295087112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD",
            "address_2": "SUITE 30",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235447",
            "telephone_number": "801-268-1715",
            "fax_number": "801-268-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5689 S REDWOOD RD",
            "address_2": "SUITE 30",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235447",
            "telephone_number": "801-268-1715",
            "fax_number": "801-268-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "BURTON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "3785956004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Fuller
• Timothy Fuller
• Trenton C. Fuller, MD
• Chase Brandon Fullerton, PA
• Tamra Fullerton, LCSW
• Chelyn Crapo Fullmer
• Christine Fullmer
• Jace Paul Fullmer, D.O.
• Jordan Tara Jaylene Fullmer
• Kent Fullmer

• Mental Health Counselor in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.