Jace Paul Fullmer, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

9415721-1204 Issued in UT

Practice address

5121 S Cottonwood St
Salt Lake City, UT 84107-5701

Phone

(801) 507-9700

NPI assigned

Mar 23, 2011

Sex

Male

Sole proprietor

No

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, HI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Emergency Physicians 151 clinicians

Hawaii Emergency Physicians Associated Inc 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Merit-based Incentive Payment System (MIPS)

Final score

89.98 of 100Reported as group

Quality

85.2

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Utah Emergency Physicians

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1588048979

  Emergency Medicine, UT

  Medicare reassignment Care Compare group NPD
• Hawaii Emergency Physicians Associated Inc

  • Emergency Medicine Physician
  • Kailua, HI
  • NPI 1801843198

  HI

  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154

  UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1407116742
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • American Fork, UT
  • NPI 1669420014
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1417460205

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450483200000",
    "number": "1306145776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "JACE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2015-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "9415721-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Brandon Fullerton, PA
• Tamra Fullerton, LCSW
• Burton Fullmer, LPC
• Chelyn Crapo Fullmer
• Christine Fullmer
• Jordan Tara Jaylene Fullmer
• Kent Fullmer
• Fully Integrative
• Jana Claire Fulmer, MSC, CMHC
• Ben E Fulton, MD

• All providers in Salt Lake City, UT
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2015; 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.