NPIMap

Individual provider Active NPI

Gregg S Fulmer, MD

  • Hospitalist Physician
  • Bellefontaine, OH
National Provider Identifier
1396781944
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35081568 Issued in OH
Practice address
205 Palmer Ave.
Bellefontaine, OH 43311-2281
Phone
(937) 592-4015
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.081568 OH
Hospitalist Physician 208M00000X 35081568 OH Primary

Addresses

Primary practice location

205 Palmer Ave.
Bellefontaine, OH 43311-2281

Mailing address

205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone (937) 593-0245

Other identifiers 8

IdentifierTypeStateIssuer
341407259OtherNATIONWIDE
341407259037OtherMEDICAL MUTUAL
87726OtherUHC
FU7340041OtherTRICARE
7755544OtherAETNA
000000026809OtherANTHEM
2369057MedicaidOH
341407259OtherCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001949 OH Practitioner - HospitalistPractitioner - Internal Medicine 5395716070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Rutan HospitalGroup PAC ID 9032013792, 90 clinicians

Practice addresses (Care Compare)

205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone (937) 592-4015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as individual
Quality
22.08
Promoting interoperability
100
Improvement activities
40
Cost
76.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35081568OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital CurrentSince Jul 1, 2004 Accepting new patients
Mary Rutan Hospital CurrentSince Jul 1, 2004 Accepting new patients
County of Logan Office of Auditor Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Buckeye Forest at Bellefontaine LLC Past Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Indian Lake Healthcare Group, LLC Past Accepting new patients

Locations

221 School St
Bellefontaine, OH 43311
Phone (937) 599-3688

1134 N Main St
Ste 1100
Bellefontaine, OH 43311
Phone (937) 651-6820

2231 Timber Trl
Bellefontaine, OH 43311
Phone (937) 599-3115

110 Dowell Ave
Bellefontaine, OH 43311
Phone (937) 593-0245

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Logan Acres Care CenterBellefontaine, OH, CCN 365768 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 31, 2025
Jan 31, 2025
Indian Lake Rehabilitation CenterLakeview, OH, CCN 365666 Skilled nursing facility Adp of the SNF Apr 2, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1396781944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E PALMER RD",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112281",
            "telephone_number": "937-593-0245",
            "fax_number": "937-592-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PALMER AVE.",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112281",
            "telephone_number": "937-592-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "GREGG",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.081568",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35081568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "341407259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "341407259037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "87726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "FU7340041",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7755544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000026809",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2369057",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "341407259",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.