Luke G Fullenkamp, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3451T444 Issued in OH

Practice address

11711 Princeton Pike Unit 941
Cincinnati, OH 45246-2500

Phone

(513) 671-0933

Fax

(513) 671-0944

NPI assigned

Apr 12, 2007

Last updated

Dec 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr Luke Fullenkamp

  • Optometrist
  • Cincinnati, OH
  • NPI 1619391836
  Authorized official Same address or phone
• Dr. Luke Fullenkamp Optometrist

  • Optometrist
  • Cincinnati, OH
  • NPI 1063831535
  Authorized official Same address or phone

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1619191368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10156 AMBERWOOD CT",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452411031",
            "telephone_number": "513-779-0685",
            "fax_number": "513-741-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 PRINCETON PIKE UNIT 941",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452462500",
            "telephone_number": "513-671-0933",
            "fax_number": "513-671-0944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9505 Colerain Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452512003",
            "country_code": "US",
            "telephone_number": "513-741-6484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLENKAMP",
        "first_name": "LUKE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3451T444",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "3451 T444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Chandhok Fulkerson, M.D., PHD
• Nicholas Fulks, PHARMD
• Full Spectrum Health Center LLC
• Full Sphere Counseling and Consulting Services, LLC
• Robin Fullbeck
• Akeem Olajuwon Fuller
• Brian J Fuller, MD
• Cali Fuller
• Catherine Fuller, LPC
• Charlotte Fuller

• Optometrist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.