Active NPI
Ronald L Fulkerson, MD PSC
- Pediatrics Physician
- Winchester, KY
National Provider Identifier
1407991011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 18417
- Practice address
- 1300 W Lexington Ave
Winchester, KY 40391 - Phone
- (859) 744-8003
- Fax
- (859) 744-2286
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 18417 | KY | Primary |
Addresses
Primary practice location
1300 W Lexington Ave
Winchester, KY 40391
Mailing address
1300 W Lexington Ave
Winchester, KY 40391
Phone (859) 744-8003
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64184179 | Medicaid | KY | |
| 65914350 | Medicaid | KY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18417 | KY | MD | Pediatrics Physician |
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": "1209081600000",
"number": "1407991011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 W LEXINGTON AVE",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "40391",
"telephone_number": "859-744-8003",
"fax_number": "859-744-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W LEXINGTON AVE",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "40391",
"telephone_number": "859-744-8003",
"fax_number": "859-744-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULKERSON",
"first_name": "RONALD",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD PSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "18417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64184179",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65914350",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, KY
- Shelby Rae Frazier
- Martha Suzanne Freeman, APRN
- Kathryn Blair Frias, APRN
- Tracey Lynne Fry, OTR/L
- Cameron Fulcher, P.T., D.P.T
- Maneesh Gaddam, M.D.
- Patricia Vanhook Gaines, PHARMD
- Garrard Pharmacists Group Inc (HCA Pharmacy & Medical Equipment)
- Garrard Pharmacists Group Inc (HCA Pharmacy & Medical Equipment)
- Tassey Garrett, MS, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.