Brooklyn Ruth Fulk, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2023034168 Issued in MO

Practice address

334 E Mount Vernon Blvd
Mount Vernon, MO 65712-2024

Phone

(417) 461-0952

NPI assigned

Nov 12, 2024

Last updated

Nov 12, 2024By the provider in NPPES

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

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Serc Rehabilitation Partners, LLC

  dba Serc

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244
  Medicare reassignment Care Compare group NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1790509115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 E MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122024",
            "telephone_number": "417-461-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULK",
        "first_name": "BROOKLYN",
        "middle_name": "RUTH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2023034168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest Edwin Emmerton III, D.O.
• Kimberly Susan Evans, DH
• David Lee Ewing, D.D.S.
• Adam Freitas
• Jill Freitas
• Joe A Gardner, MD
• Brian Christopher George, HIS
• John Scott George, BC-HIS
• Glenda Marie Gillaspy, BC-HIS
• Mauricio Gomez, M.D.

• Physical Therapist in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.