Active NPI
Connie D. Fulmer, D.C.
- Chiropractor
- Kingsport, TN
National Provider Identifier
1710242896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2577
- Practice address
- 150 Clinic Dr Ste C
Kingsport, TN 37663-2254 - Phone
- (423) 726-2668
- Fax
- (423) 726-2667
- NPI assigned
- Jul 5, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2577 | TN | Primary |
Addresses
Primary practice location
150 Clinic Dr Ste C
Kingsport, TN 37663-2254
Mailing address
PO Box 6024
Kingsport, TN 37663-1024
Phone (423) 726-2668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2577 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1710242896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6024",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376631024",
"telephone_number": "423-726-2668",
"fax_number": "423-726-2667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CLINIC DR STE C",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376632254",
"telephone_number": "423-726-2668",
"fax_number": "423-726-2667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULMER",
"first_name": "CONNIE",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-05",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "2577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.