Active NPI
Carolyn N Fulton, LSA
- Surgical Assistant
- Temple, TX
National Provider Identifier
1336252154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- SA00205
- Practice address
- 4907 Parkside Dr
Temple, TX 76502-5707 - Phone
- (254) 654-0404
- NPI assigned
- Aug 16, 2006
- 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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | SA00205 | TX | Primary |
Addresses
Primary practice location
4907 Parkside Dr
Temple, TX 76502-5707
Mailing address
4907 Parkside Dr
Temple, TX 76502-5707
Phone (254) 654-0404
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 |
|---|---|---|---|
| SA00205 | TX | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240531200000",
"number": "1336252154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4907 PARKSIDE DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765025707",
"telephone_number": "254-654-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4907 PARKSIDE DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765025707",
"telephone_number": "254-654-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "CAROLYN",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "LSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2009-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "SA00205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.