Individual provider Active NPI

Kathryn M Fulghum, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1649616988
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-75971 Issued in KS
Practice address
3600 E Harry St
Wichita, KS 67218-3713
Phone
(316) 689-5475
Fax
(316) 691-6772
NPI assigned
May 14, 2013
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-75971 KS Primary

Addresses

Primary practice location

3600 E Harry St
Wichita, KS 67218-3713

Mailing address

12114 E Mainsgate St
Wichita, KS 67226-4528
Phone (316) 619-7729

Other identifiers 2

IdentifierTypeStateIssuer
1101723267OtherMEDICARE
2010725400AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140128000620 KS Practitioner - Nurse Practitioner 1658500418 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-75971KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Apr 3, 2023 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Apr 3, 2023 Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients

Locations

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

901 SW Garfield Ave
Topeka, KS 66606

Interoperability endpoints

  • Direct secure messaging: kfulghum127008@stormontvaildirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1649616988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12114 E MAINSGATE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264528",
            "telephone_number": "316-619-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183713",
            "telephone_number": "316-689-5475",
            "fax_number": "316-691-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULGHUM",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-75971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1101723267",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010725400A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.