NPIMap

Organization Active NPI

Fulton Family Medicine,PLLC

  • Family Medicine Physician
  • Vashon, WA
National Provider Identifier
1629352984
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00027813 Issued in WA
Legal business name
FULTON FAMILY MEDICINE,PLLC
Practice address
17639 100TH Ave SW
Vashon, WA 98070-5234
Phone
(206) 463-3696
NPI assigned
Oct 5, 2011
Last updated
Jan 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Dr. Gail Lynn Fulton, M.D.
Title
Physician Owner
Phone
(206) 463-3696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00027813 WA Primary

Addresses

Primary practice location

17639 100TH Ave SW
Vashon, WA 98070-5234

Mailing address

PO Box N
Vashon, WA 98070-0360
Phone (206) 463-3696

Other identifiers 1

IdentifierTypeStateIssuer
8126757MedicaidWA

Other names 1

  • Vashon Plaza Medical Clinic Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1629352984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX N",
            "city": "VASHON",
            "state": "WA",
            "postal_code": "980700360",
            "telephone_number": "206-463-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17639 100TH AVE SW",
            "city": "VASHON",
            "state": "WA",
            "postal_code": "980705234",
            "telephone_number": "206-463-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON FAMILY MEDICINE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "206-463-3696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00027813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8126757",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vashon Plaza Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vashon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.