Spencer Fullmer

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

590 Antelope Blvd
Red Bluff, CA 96080-2474

Phone

(530) 529-9454

NPI assigned

Mar 13, 2024

Sex

Male

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

Practice roles

Locations

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.

• His Ideas, Inc

  • Community/Behavioral Health Agency
  • Red Bluff, CA
  • NPI 1568641470
  NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1609635689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 ANTELOPE BLVD STE 40A",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802477",
            "telephone_number": "530-529-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ANTELOPE BLVD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802474",
            "telephone_number": "530-529-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "SPENCER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Freeze, AA SOCIAL SCIE, MHRS
• Sheila Froebe
• Michael Gregory Froke
• Frontier Village Family Health Center, Inc
• Jack L Fry, DDS
• Cynthia Louise Funderburk
• Nick Hadrian Gabriel, D.O.
• Savannah Gafford
• Selene Patricia Galvan
• Margaret A Gambetta, PPS

• All providers in Red Bluff, CA
• Health & Wellness Coach in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.