Active NPI
Bryan Fulkersin, FNP-C
- Family Nurse Practitioner
- Hickory, NC
National Provider Identifier
1376990457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F0516286
- Practice address
- 1270 25TH Street PL SE
Hickory, NC 28602-9657 - Phone
- (910) 228-7538
- NPI assigned
- May 19, 2016
- Last updated
- Nov 21, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0516286 | NC | Primary |
Addresses
Primary practice location
1270 25TH Street PL SE
Hickory, NC 28602-9657
Mailing address
1270 25TH Street PL SE
Hickory, NC 28602-9657
Phone (910) 228-7538
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0516286 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandy Shores Primary Care, PLLC | Current | Accepting new patients | |
| Optimal Man, PLLC | Current | Accepting new patients |
Locations
13741 NC Highway 50
Ste A
Surf City, NC 28445
Phone (910) 777-2732
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Hickory, NC
- NPI 1841066362
-
- Primary Care Clinic/Center
- Surf City, NC
- NPI 1508511767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1376990457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 25TH STREET PL SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286029657",
"telephone_number": "910-228-7538",
"fax_number": "910-777-2742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 25TH STREET PL SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286029657",
"telephone_number": "910-228-7538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULKERSIN",
"first_name": "BRYAN",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "F0516286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hickory, NC
- Fryecare Valdese, LLC (FryeCare Internal Medicine - Hickory)
- Fryecare Women's Services, LLC
- Fryecare Women's Services, LLC (Piedmont OBGYN)
- Abagail Fuhrman
- Abigail Paige Fulk
- Nathaniel Asbury Fuller, PA-C
- Peggy Carlene Furr, MPT
- Tina S Furr, OTR/L
- G&N Medical, PLLC (HighER Level Urgent Care)
- Gadoury Chiropractic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.