Active NPI
Bonnie A. Fulghum, LMBT
- Massage Therapist
- Kenly, NC
National Provider Identifier
1447600937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 14869
- Practice address
- 7617 Fulghum Rd
Kenly, NC 27542-8202 - Phone
- (252) 289-3786
- NPI assigned
- Jun 15, 2016
- Last updated
- Jun 15, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 14869 | NC | Primary |
Addresses
Primary practice location
7617 Fulghum Rd
Kenly, NC 27542-8202
Mailing address
7617 Fulghum Rd
Kenly, NC 27542-8202
Phone (252) 289-3786
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465948800000",
"number": "1447600937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7617 FULGHUM RD",
"city": "KENLY",
"state": "NC",
"postal_code": "275428202",
"telephone_number": "252-289-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7617 FULGHUM RD",
"city": "KENLY",
"state": "NC",
"postal_code": "275428202",
"telephone_number": "252-289-3786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULGHUM",
"first_name": "BONNIE",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2016-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "14869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenly, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.