Organization Active NPI

Patricia M. Fulmer, O.D., L.L.C.

  • Optometrist
  • Huntsville, AL
National Provider Identifier
1831708767
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PATRICIA M. FULMER, O.D., L.L.C.
Practice address
11310 Memorial Pkwy SW Ste G
Huntsville, AL 35803-2666
Phone
(256) 653-8847
NPI assigned
Jul 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Patricia Fulmer, O.D.NPI 1013340371
Title
Member Manager
Phone
(256) 653-8847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

11310 Memorial Pkwy SW Ste G
Huntsville, AL 35803-2666

Mailing address

14034 Green Way Park Cir SE
Huntsville, AL 35803-5200
Phone (256) 653-8847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201209002392 AL Part B Supplier - Clinic/Group Practice 1355753716 Receives reassigned benefits from 2 practitioners
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Locations

11310 Memorial Pkwy SW
Ste G
Huntsville, AL 35803
Phone (256) 653-8847

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1831708767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14034 GREEN WAY PARK CIR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358035200",
            "telephone_number": "256-653-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11310 MEMORIAL PKWY SW STE G",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358032666",
            "telephone_number": "256-653-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA M. FULMER, O.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "256-653-8847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.