Mackenzie Fulmer

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL012188 Issued in PA

Practice address

841 Western Ave Apt 4
Pittsburgh, PA 15233-1743

Phone

(216) 789-3431

NPI assigned

Jun 12, 2015

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1669853867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 WATERFRONT PL APT 158",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152225705",
            "telephone_number": "216-789-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 WESTERN AVE APT 4",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152331743",
            "telephone_number": "216-789-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMChospital@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1909 Waterfront Pl Apt 158",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152225705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zachary Lee Fuller, MD
• Christopher Damien Fullerton, CRNP, PMHNP-BC
• Elise Fullerton, CRNP
• Kiele Fullerton
• Kathleen Fullmer, LPC
• Tara Fulmor
• Jacob Fulton, DPT
• James George Fulton, B.A.
• Jeffrey A Fulton, DO
• Mark A Fulton, R.PH., PHARM.D.

• Speech-Language Pathologist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.