Active NPI
Susan Elizabeth Fulton, MS
- Audiologist
- Cape Girardeau, MO
National Provider Identifier
1811908221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2017034344
- Practice address
- 1727 Themis St
Cape Girardeau, MO 63701-5223 - Phone
- (573) 290-2493
- NPI assigned
- Aug 10, 2006
- Reactivated
- Nov 26, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2017034344 | MO | Primary |
Addresses
Primary practice location
1727 Themis St
Cape Girardeau, MO 63701-5223
Mailing address
1727 Themis St
Cape Girardeau, MO 63701-5223
Phone (573) 290-2493
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017034344 | MO | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1811908221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1727 THEMIS ST",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637015223",
"telephone_number": "573-290-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1727 THEMIS ST",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637015223",
"telephone_number": "573-290-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"deactivation_date": "2007-07-17",
"reactivation_date": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "2017034344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.