Active NPI
Kristen Fulton, M.D.
- Internal Medicine Physician
- La Vista, NE
National Provider Identifier
1861542854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19954
- Practice address
- 8248 S 96TH St
La Vista, NE 68128-3126 - Phone
- (402) 717-9500
- Fax
- (402) 717-9501
- NPI assigned
- Jan 11, 2007
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19954 | NE | Primary |
Addresses
Primary practice location
8248 S 96TH St
La Vista, NE 68128-3126
Mailing address
PO Box 642117
Omaha, NE 68164-8117
Phone (402) 398-6254
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19954 | NE | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- kfulton8529@achce.catholichealth.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421280000000",
"number": "1861542854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 642117",
"city": "OMAHA",
"state": "NE",
"postal_code": "681648117",
"telephone_number": "402-398-6254",
"fax_number": "402-829-8513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8248 S 96TH ST",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681283126",
"telephone_number": "402-717-9500",
"fax_number": "402-717-9501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "KRISTEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2015-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NE",
"license": "19954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vista, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.