Individual provider Active NPI

Zachary Bennett Fulkerson, MD., PHD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1386080265
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01076478A Issued in IN
Practice address
1120 W Michigan St # Cl285
Indianapolis, IN 46202-5209
Phone
(317) 278-0042
NPI assigned
May 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01076478A IN
Pulmonary Disease Physician 207RP1001X 01076478A IN
Internal Medicine Physician 207R00000X 01076478A IN Primary

Addresses

Primary practice location

1120 W Michigan St # Cl285
Indianapolis, IN 46202-5209

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

IdentifierTypeStateIssuer
300025978MedicaidIN
000001275067OtherINANTHEM PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address zfulkerson@direct.iuhealth.org
Direct Messaging Address zfulkerson@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190528001789 IN Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 5294975330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
01076478AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Indiana Clinic Critical Care LLC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2574 Reliable Pkwy
Chicago, IL 60686

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

1115 Ronald Reagan Pkwy
Ste 206
Avon, IN 46123
Phone (317) 217-2888

1111 Ronald Reagan Pkwy
Rm 12028
Avon, IN 46123
Phone (317) 217-3257

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1801 Senate Blvd
Ste 2000
Indianapolis, IN 46202
Phone (317) 962-0500

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

Interoperability endpoints

  • Direct secure messaging: zfulkerson14449@direct.eskenazihealth.edu
  • Direct secure messaging: zfulkerson@direct.iuhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1386080265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST # CL285",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-278-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "ZACHARY",
        "middle_name": "BENNETT",
        "credential": "MD., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-17",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01076478A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01076478A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01076478A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025978",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001275067",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfulkerson@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1120 W Michigan St # Cl285",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zfulkerson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.