Dean Roy Fullingim, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1610 Issued in OK

Practice address

744 W 9TH St
Tulsa, OK 74127-9020

Phone

(918) 728-6194

Fax

(918) 664-2521

NPI assigned

Nov 2, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in OK, TX, NM3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
• FHIR API: https://fhir-usa.unify.chbase.com/org/artesia-6a02e1ef

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Choctaw Nation of Oklahoma

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Albuquerque Indian Health Center

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1659458917

  TX

  Medicare reassignment NPD
• Artesia General Hospital

  • Surgery Physician
  • Artesia, NM
  • NPI 1114076825
  Medicare reassignment NPD
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Taos Picuris Health Center

  • Clinic/Center
  • Taos, NM
  • NPI 1548372071

  TX

  Medicare reassignment NPD
• Zuni Indian Hospital

  • General Acute Care Hospital
  • Zuni, NM
  • NPI 1497843734

  TX

  Medicare reassignment NPD
• Cherokee Nation

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1770574253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "SUITE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6194",
            "fax_number": "918-664-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-728-6194",
            "fax_number": "918-664-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLINGIM",
        "first_name": "DEAN",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "1610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100093690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl Fuller Jr., LMSW
• Cynthia J. Fuller, M.D.
• Jennifer Kathryn Fuller, MA, LPC
• Latisha Fuller
• Terrance Fuller
• Jeremy Scott Fullingim, D.O.
• Ty Fullingim
• Michelle Fulmer
• Ashley Michelle Fulp
• Chelsey Fulps

• Diagnostic Radiology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Diagnostic Radiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.