Mary E Fultz III

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

NONE

Practice address

205 E Chestnut Ave
Ponca City, OK 74601-4311

Phone

(580) 762-9109

Fax

(580) 763-0929

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588784151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 BRADBARY LN",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012512",
            "telephone_number": "580-765-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E CHESTNUT AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746014311",
            "telephone_number": "580-762-9109",
            "fax_number": "580-763-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie Frank
• Susan Leigh Fraser
• Lily Rebekah Friedl, OTR/L
• Kristianna Fuentes, LPN
• John A Fultz
• Heather Dawn Fusselman
• Willow Lee Gahr
• Courtney Gallimore
• Christine J Gann
• Michelle Gann

• Case Manager/Care Coordinator in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.