Misty Marie Fullerton, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8252 Issued in AZ

Practice address

2801 W Northern Ave
Phoenix, AZ 85051-6646

Phone

(602) 242-7537

Fax

(602) 242-4169

NPI assigned

Jul 2, 2012

Last updated

Jul 2, 2012By the provider in NPPES

Sex

Female

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arizona Life Chiropractic Center, LLC

  • Chiropractor
  • Phoenix, AZ
  • NPI 1619134327
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1508120700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W NORTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516646",
            "telephone_number": "602-242-7537",
            "fax_number": "602-242-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W NORTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516646",
            "telephone_number": "602-242-7537",
            "fax_number": "602-242-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "MISTY",
        "middle_name": "MARIE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan L Fuller, O.D.
• Carolyn M Fuller, ND
• Jennifer Fuller
• Laura Lyn Fuller, SLP
• Lisa Marie Fuller, OTR/L
• Jonathan Daniel Fullner, M.D.
• Samaiyah Fullylove
• Shane Amour Fulton, CNA , MD
• Latricia Funches, RN
• Yvonne Maria Funcke, MD

• Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.