Individual provider Active NPI

Jared Whitford Fulcher, PTA

  • Physical Therapy Assistant
  • New Bern, NC
National Provider Identifier
1326520974
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A6254 Issued in NC
Practice address
2600 Old Cherry Point Rd
New Bern, NC 28560-6778
Phone
(252) 637-4730
NPI assigned
Aug 30, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A6254 NC Primary

Addresses

Primary practice location

2600 Old Cherry Point Rd
New Bern, NC 28560-6778

Mailing address

1690 Core Point Rd
Ernul, NC 28527-9503
Phone (252) 229-9596

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

LicenseStateTypeSpecialty
A6254NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1326520974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 CORE POINT RD",
            "city": "ERNUL",
            "state": "NC",
            "postal_code": "285279503",
            "telephone_number": "252-229-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OLD CHERRY POINT RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285606778",
            "telephone_number": "252-637-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCHER",
        "first_name": "JARED",
        "middle_name": "WHITFORD",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A6254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.