Individual provider Active NPI

Debra Fulton

  • Registered Nurse
  • Viera, FL
National Provider Identifier
1871952168
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1304042 Issued in FL
Practice address
2565 Judge Fran Jamieson Way
Viera, FL 32940-5998
Phone
(321) 639-5858
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1304042 FL Primary

Addresses

Primary practice location

2565 Judge Fran Jamieson Way
Viera, FL 32940-5998

Mailing address

2565 Judge Fran Jamieson Way
Viera, FL 32940
Phone (321) 639-5858

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

State licenses

LicenseStateTypeSpecialty
1304042FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1871952168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-639-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329405998",
            "telephone_number": "321-639-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "1304042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.