NPIMap

Organization Active NPI

Hopeful Chiropractic LLC

Doing business as Fuller Life Chiropractic

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1649715822
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8466 Issued in AZ
Legal business name
HOPEFUL CHIROPRACTIC LLC
Doing business as
Fuller Life Chiropractic
Practice address
1728 S Greenfield Rd
Suite 109
Mesa, AZ 85206-3485
Phone
(480) 744-0186
NPI assigned
Dec 27, 2016
Last updated
Dec 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Dr. Rex Dustin Fuller, DCNPI 1043755143
Title
Co Owner
Phone
(480) 744-0186

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8466 AZ Primary

Addresses

Primary practice location

1728 S Greenfield Rd
Suite 109
Mesa, AZ 85206-3485

Mailing address

1728 S Greenfield Rd
Suite 109
Mesa, AZ 85206-3485
Phone (480) 744-0186

Other names 1

  • Fuller Life Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170113001688 AZ Part B Supplier - Clinic/Group Practice 5395027973 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

1347 N Greenfield Rd
Ste 102
Mesa, AZ 85205
Phone (480) 744-0186

Practitioners & affiliated clinicians

Practitioners 5

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": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1649715822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 S GREENFIELD RD",
            "address_2": "SUITE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063485",
            "telephone_number": "480-744-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 S GREENFIELD RD",
            "address_2": "SUITE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063485",
            "telephone_number": "480-744-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPEFUL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "DUSTIN",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "480-744-0186",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuller Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.