Individual provider Active NPI

Corey Lee Fulk, D.C.

  • Chiropractor
  • Olathe, KS
National Provider Identifier
1588827927
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05205 Issued in KS
Practice address
2110 E Santa Fe St
Olathe, KS 66062-1607
Phone
(913) 764-6237
Fax
(913) 397-8230
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05205 KS Primary

Addresses

Primary practice location

2110 E Santa Fe St
Olathe, KS 66062-1607

Mailing address

2110 E Santa Fe St
Olathe, KS 66062-1607
Phone (913) 764-6237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000548 KS Practitioner - Chiropractic 0143393744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fulk Chiropractic PAGroup PAC ID 1254324544, 7 clinicians

Practice addresses (Care Compare)

2110 E Santa Fe
Olathe, KS 66062-1607
Phone (913) 764-6237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05205KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fulk Chiropractic PA Chiropractor CurrentSince Oct 4, 2010 Accepting new patients

Locations

2110 E Santa Fe St
Olathe, KS 66062
Phone (913) 764-6237

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1588827927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E SANTA FE ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621607",
            "telephone_number": "913-764-6237",
            "fax_number": "913-397-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E SANTA FE ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621607",
            "telephone_number": "913-764-6237",
            "fax_number": "913-397-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULK",
        "first_name": "COREY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.