Susan Fullerton, SPEECH LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

220203920 Issued in VA

Practice address

288 Lancer Lane
Martinsville, VA 24112

Phone

(276) 638-1022

NPI assigned

Feb 19, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1780184523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 HOLLY ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272887678",
            "telephone_number": "276-638-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 LANCER LANE",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "24112",
            "telephone_number": "276-638-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "SUSAN",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "220203920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Free Medical Clinic of Martinsville & Henry County
• Friedrichs Family Eye Center PC
• Gray W. Friedrichs, O.D.
• Susan Lynn Frye-Yarbrough
• Tina Fulcher, COTA/L
• G a Stermer Jr., DDS LLC
• G.a.P.S. Healthcare PLLC
• Holly Ann Gaeta, PHARMD
• Mackenzie Gaetano, PT, DPT
• Richard Scott Galos, M.D.

• Speech-Language Pathologist in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.