Lee Ann Fulper Waller, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305208101 Issued in VA

Practice address

47 Depot St
Chatham, VA 24531-5518

Phone

(434) 432-0028

Fax

(434) 432-0062

NPI assigned

Jul 14, 2016

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

Other names 1

• Lee Ann Bennett Fulper Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1912350935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST",
            "address_2": "SUITE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 DEPOT ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245315518",
            "telephone_number": "434-432-0028",
            "fax_number": "434-432-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "LEE ANN",
        "middle_name": "FULPER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE ANN",
            "last_name": "FULPER",
            "middle_name": "BENNETT",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Latasha M Vamper
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• Denise Stickel Walker
• Kaitlyn Lipscomb Wall, M.S, ED.S., NCSP
• Weaver Associates, PC
• Christie Altice Weaver, O.D.
• Lauren Y Weaver, FNP
• West Piedmont Healthcare Group, Inc.
• Jaclyn Marie Westfall, ATC

• Physical Therapist in Chatham, VA
• Providers in Chatham, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.