Individual provider Active NPI

Taylor Fulbright

  • Counselor
  • Tulsa, OK
National Provider Identifier
1356930457
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
650 S Peoria Ave
Tulsa, OK 74120-4429
Phone
(918) 587-9471
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X OK Primary

Addresses

Primary practice location

650 S Peoria Ave
Tulsa, OK 74120-4429

Mailing address

650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 587-9471

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241104003560 OK Practitioner - Mental Health Counselor 1355874918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11245OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children'S Services, Inc CurrentSince Oct 4, 2024 Accepting new patients
Family & Children'S Services, Inc CurrentSince Oct 4, 2024 Accepting new patients

Locations

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1356930457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204429",
            "telephone_number": "918-587-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204429",
            "telephone_number": "918-587-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULBRIGHT",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.