Marcus Jevon Fulton, NREMT-B

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

B1595888 Issued in LA

Practice address

964 Winter Garden Dr Unit 1
Shreveport, LA 71107-3129

Phone

(318) 221-0467

NPI assigned

Mar 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1396916680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 WINTER GARDEN DR UNIT 1",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711073129",
            "telephone_number": "318-221-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 WINTER GARDEN DR UNIT 1",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711073129",
            "telephone_number": "318-221-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MARCUS",
        "middle_name": "JEVON",
        "credential": "NREMT-B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "LA",
            "license": "B1595888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Basic Emergency Medical Technician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Basic Emergency Medical Technician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.