Active NPI
Joe W Fuller, PT
- Physical Therapist
- Torrington, WY
National Provider Identifier
1417912403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT298
- Practice address
- 1301 E M St
Ste B
Torrington, WY 82240-3521 - Phone
- (307) 532-4694
- Fax
- (307) 532-7241
- NPI assigned
- Apr 20, 2006
- Last updated
- Nov 21, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT298 | WY | Primary |
Addresses
Primary practice location
1301 E M St
Ste B
Torrington, WY 82240-3521
Mailing address
1301 E M St
Ste B
Torrington, WY 82240-3521
Phone (307) 532-4694
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F232037 | Other | MIDLANDS CHOICE |
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 |
|---|---|---|---|
| PT298 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195603200000",
"number": "1417912403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 E M ST",
"address_2": "STE B",
"city": "TORRINGTON",
"state": "WY",
"postal_code": "822403521",
"telephone_number": "307-532-4694",
"fax_number": "307-532-7241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 E M ST",
"address_2": "STE B",
"city": "TORRINGTON",
"state": "WY",
"postal_code": "822403521",
"telephone_number": "307-532-4694",
"fax_number": "307-532-7241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "JOE",
"middle_name": "W",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-20",
"last_updated": "2007-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT298",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "F232037",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Torrington, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.