Tamie Lee Fullerton, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

6084 Issued in CA

Practice address

4560 SE International Way
Suite 100 Consonus Healthcare Services
Milwaukee, WI 97222

Phone

(971) 206-5129

Fax

(971) 206-5209

NPI assigned

Mar 12, 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

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629100607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "SUITE 100 CONSONUS HEALTHCARE SERVICES",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "97222",
            "telephone_number": "971-206-5129",
            "fax_number": "971-206-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "SUITE 100 CONSONUS HEALTHCARE SERVICES",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "97222",
            "telephone_number": "971-206-5129",
            "fax_number": "971-206-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "TAMIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "6084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geneva Fuller, SAC-IT
• Julie A Fuller, MD
• Mary Fuller
• Patrick J Fuller, MD
• Shauna Fuller, PHD
• Daniel Creighton Fullin, M.D.
• Tanner Michael Fullmer
• Fully Loaded LLC
• Kristen Lynn Fulmer, MS RD CD
• Cole Fulton

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• 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.