Active NPI
Kenya Fulton
- Private Vehicle
- Matteson, IL
National Provider Identifier
1720779663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- Practice address
- 931 Central Ave
Matteson, IL 60443-1542 - Phone
- (833) 534-2639
- NPI assigned
- May 19, 2023
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | Primary |
Addresses
Primary practice location
931 Central Ave
Matteson, IL 60443-1542
Mailing address
1041 Monterey CT
University Park, IL 60484-3236
Phone (708) 664-1250
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amex Global Transportation LLC | Private Vehicle | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Private Vehicle
- Matteson, IL
- NPI 1376221853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684454400000",
"number": "1720779663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1041 MONTEREY CT",
"city": "UNIVERSITY PARK",
"state": "IL",
"postal_code": "604843236",
"telephone_number": "708-664-1250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 CENTRAL AVE",
"city": "MATTESON",
"state": "IL",
"postal_code": "604431542",
"telephone_number": "833-534-2639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "KENYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-19",
"last_updated": "2023-05-19",
"certification_date": "2023-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matteson, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.