Active NPI
Cynthia Moon Fulton, LCSW
- Clinical Social Worker
- Frankfort, KY
National Provider Identifier
1700843653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1240
- Practice address
- 130 Kings Daughters Dr
Frankfort, KY 40601-4248 - Phone
- (502) 226-3300
- Fax
- (502) 223-7491
- NPI assigned
- Apr 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1240 | KY | Primary |
Addresses
Primary practice location
130 Kings Daughters Dr
Frankfort, KY 40601-4248
Mailing address
130 Kings Daughters Dr
Frankfort, KY 40601-4248
Phone (502) 226-3300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2081005 | Other | KY | CIGNA |
| 00483445 | Other | KY | ANTHEM |
| 7100336590 | Medicaid | KY |
Other names 1
- Cindi Moon Fulton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061214000263 | KY | Practitioner - Clinical Social Worker | 3870592157 | Practice locations: Frankfort, KY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1240 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623456000000",
"number": "1700843653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 KINGS DAUGHTERS DR",
"city": "FRANKFORT",
"state": "KY",
"postal_code": "406014248",
"telephone_number": "502-226-3300",
"fax_number": "502-223-7491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 KINGS DAUGHTERS DR",
"city": "FRANKFORT",
"state": "KY",
"postal_code": "406014248",
"telephone_number": "502-226-3300",
"fax_number": "502-223-7491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "CYNTHIA",
"middle_name": "MOON",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-26",
"last_updated": "2021-06-12",
"certification_date": "2021-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "1240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2081005",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "00483445",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100336590",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CINDI",
"last_name": "FULTON",
"middle_name": "MOON",
"credential": "LCSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Frankfort, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.