Kaitlin Mary Fulton, PT, DPT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

004955 Issued in NY

Practice address

4400 Vestal Pkwy E
Binghamton, NY 13902-4400

Phone

(607) 777-7011

NPI assigned

May 22, 2020

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1700409950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 VINE ST",
            "city": "LARKSVILLE",
            "state": "PA",
            "postal_code": "186511804",
            "telephone_number": "570-690-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PKWY E",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139024400",
            "telephone_number": "607-777-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "KAITLIN",
        "middle_name": "MARY",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028351",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT008198",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "004955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco Frias, MD
• Maryann Fritsch, RN, MS
• Amy Elizabeth Frost, RN
• Amanda Fuller
• Stephanie R Fuller
• Lucas Leandro Fustinoni Lourenco
• Mary Kate Gaetani, NP
• Teresa Gaetani, LMSW
• Anne Gainsback, MSOTR/L
• Benjamin M Gajdorus, LCSW

• Athletic Trainer in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.