Active NPI
Karen R Fullwood, HIS
- Hearing Instrument Specialist
- Nottingham, MD
National Provider Identifier
1366587990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 02431
- Practice address
- 4134 E Joppa Rd Ste 101
Nottingham, MD 21236-2277 - Phone
- (410) 256-1006
- Fax
- (410) 256-0088
- NPI assigned
- Feb 21, 2007
- Last updated
- Oct 9, 2019
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 02431 | MD | Primary |
Addresses
Primary practice location
4134 E Joppa Rd Ste 101
Nottingham, MD 21236-2277
Mailing address
4134 E Joppa Rd Ste 101
Nottingham, MD 21236-2277
Phone (410) 256-1006
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 |
|---|---|---|---|
| 02431 | MD | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Ellen Padusi | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570579200000",
"number": "1366587990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4134 E JOPPA RD STE 101",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212362277",
"telephone_number": "410-256-1006",
"fax_number": "410-256-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4134 E JOPPA RD STE 101",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212362277",
"telephone_number": "410-256-1006",
"fax_number": "410-256-0088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLWOOD",
"first_name": "KAREN",
"middle_name": "R",
"credential": "HIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2019-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MD",
"license": "02431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nottingham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.