Active NPI
James Darrell Fullmer, RPH
- Pharmacist
- Ephraim, UT
National Provider Identifier
1508901174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 130934
- Practice address
- 475 S Main St
Ephraim, UT 84627-4017 - Phone
- (435) 283-0340
- NPI assigned
- Feb 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 130934 | UT | Primary |
Addresses
Primary practice location
475 S Main St
Ephraim, UT 84627-4017
Mailing address
475 S Main St
Ephraim, UT 84627-4017
Phone (435) 283-0340
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130934 | UT | MD | Pharmacist |
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": "1272326400000",
"number": "1508901174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 S MAIN ST",
"city": "EPHRAIM",
"state": "UT",
"postal_code": "846274017",
"telephone_number": "435-283-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 S MAIN ST",
"city": "EPHRAIM",
"state": "UT",
"postal_code": "846274017",
"telephone_number": "435-283-0340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLMER",
"first_name": "JAMES",
"middle_name": "DARRELL",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2010-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "130934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ephraim, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.