Individual provider Active NPI

Charles L Fulton, D.C.

  • Chiropractor
  • Fort Myers, FL
National Provider Identifier
1689630998
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6762 Issued in FL
Practice address
8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858
Phone
(239) 275-0770
Fax
(239) 275-5770
NPI assigned
Apr 25, 2006
Last updated
Oct 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6762 FL Primary

Addresses

Primary practice location

8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858

Mailing address

8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858
Phone (239) 275-0770

Other identifiers 1

IdentifierTypeStateIssuer
22993XOtherFLMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040521000222 FL Practitioner - Chiropractic 3274524905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8841 College Pkwy
Suite 102
Fort Myers, FL 33919-4858
Phone (239) 275-0770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH6762FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fulton Chiropractic P a Chiropractor CurrentSince Oct 26, 2006 Accepting new patients
NW Health Services LLC Chiropractor PastSince Feb 25, 2024 Accepting new patients
Dr Senne Health Consultant LLC Chiropractor PastSince Oct 26, 2006 Accepting new patients
Spain Wellness Center Inc Chiropractor PastSince Jul 1, 2000 Accepting new patients

Locations

8841 College Pkwy
Ste 102
Fort Myers, FL 33919
Phone (239) 275-0770

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1689630998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8841 COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194858",
            "telephone_number": "239-275-0770",
            "fax_number": "239-275-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8841 COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194858",
            "telephone_number": "239-275-0770",
            "fax_number": "239-275-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "22993X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.