James Matthew Fulmer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3582 Issued in AR

Practice address

562 Locust St
Conway, AR 72034-5349

Phone

(501) 327-7778

Fax

(501) 327-1736

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matt Fulmer D.D.S., P.a.

  • Dental Clinic/Center
  • Conway, AR
  • NPI 1871838128
  NPD (past) Authorized official
• Terry L. Fiddler, D.D.S., P.a.

  • General Practice Dentistry
  • Conway, AR
  • NPI 1881789865
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710100995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 LOCUST ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345349",
            "telephone_number": "501-327-7778",
            "fax_number": "501-327-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 LOCUST ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345349",
            "telephone_number": "501-327-7778",
            "fax_number": "501-327-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "JAMES",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Fuller, RD LD CLC
• Nichole Fuller
• Pamela Fuller, RECOVERY ASSISTANT
• Tammie Fuller, RECOVERY ASSISTANT
• Chad Coleman Fulmer, D.D.S.
• James R Fulmer Jr., M.D.
• Robert Fulmer, RECOVERY ASSISTANT
• Adam Funmaker, MHPP
• William Charles Furlow, MD
• Garett Mitchell Fusilier

• General Practice Dentistry in Conway, AR
• Providers in Conway, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.