Michael G Fulton, P. T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1336 Issued in MS

Practice address

2170 S Lamar Blvd
Oxford, MS 38655-5224

Phone

(662) 234-8559

Fax

(662) 234-7923

NPI assigned

Jun 16, 2005

Last updated

May 14, 2013By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Professional Therapy Services Inc

  • Physical Therapist
  • Oxford, MS
  • NPI 1801968318
  NPD (past) Authorized official

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1710982673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 JACKSON AVE W",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555416",
            "telephone_number": "662-234-8559",
            "fax_number": "662-234-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555224",
            "telephone_number": "662-234-8559",
            "fax_number": "662-234-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "P. T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51511964",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51511964",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "650021553",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120446",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freds Stores of Tennessee Inc (Freds Xpress 3888)
• Pamela Mashelle Frost, M.S.
• Shannon Michelle Fryery, NP
• Amber Fuller, M.A.
• Dene M. Fulton, P.T.
• G & M of Oxford, Inc (G and M Pharmacy LTC)
• G & M of Oxford, Inc (G & M Pharmacy)
• G and M Pharmacy
• Barbara Michelle Gage, MA, CCC-SLP
• Haley Paige Matkins Gaines, DPT

• Physical Therapist in Oxford, MS
• Providers in Oxford, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.