Fultz Physical Therapy and Joint Rehab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FULTZ PHYSICAL THERAPY AND JOINT REHAB, LLC

Practice address

9462 Ellerbe Rd Ste 200
Shreveport, LA 71106-7466

Phone

(318) 606-5262

Fax

(318) 402-0802

NPI assigned

Oct 16, 2018

Organization subpart

No

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

Authorized official

Name

Christopher Fultz, P.T.NPI 1952790917

Title

P.T./Owner

Phone

(318) 606-5262

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 12

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

• Christopher Fultz, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1952790917
  Medicare reassignment Care Compare group NPD Authorized official
• Evelyn Bordovsky, PT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1386483188
  Medicare reassignment Care Compare group NPD
• Justin Michael Boyd, PT, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1174012330
  Medicare reassignment Care Compare group NPD
• Morgan Griffin Howell, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1275106379
  Medicare reassignment Care Compare group NPD
• Ashley M McCollough, P.T.

  • Physical Therapist
  • Shreveport, LA
  • NPI 1235755240
  Medicare reassignment Care Compare group NPD
• Caleb T McEntire, P.T.

  • Physical Therapist
  • Shreveport, LA
  • NPI 1457996316
  Medicare reassignment Care Compare group NPD
• Kelli S Snyder, DPT, PT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1083179170
  Medicare reassignment Care Compare group NPD
• Zachary Jon Voss, PT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1962162198
  Medicare reassignment Care Compare group NPD
• Mason L McGee, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1871926360
  Medicare reassignment NPD
• Bailee Claire Lipari, DPT

  • Physical Therapist
  • Bossier City, LA
  • NPI 1730010117
  NPD
• Taylor Beckett, PTA

  • Physical Therapy Assistant
  • Shreveport, LA
  • NPI 1942023684
  NPD (past)
• Karie Pope McEntire, PT, DPT

  • Physical Therapist
  • Shreveport, LA
  • NPI 1962067207
  NPD (past)

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1912473034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9462 ELLERBE RD STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067466",
            "telephone_number": "318-606-5262",
            "fax_number": "318-402-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9462 ELLERBE RD STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067466",
            "telephone_number": "318-606-5262",
            "fax_number": "318-402-0802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5795 N Market St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711072527",
            "country_code": "US",
            "telephone_number": "318-489-4298",
            "fax_number": "318-489-4299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2642 Youree Dr",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711043616",
            "country_code": "US",
            "telephone_number": "318-716-1664",
            "fax_number": "318-402-0802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULTZ PHYSICAL THERAPY AND JOINT REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "P.T./OWNER",
        "authorized_official_telephone_number": "318-606-5262",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952790917",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precious Lorrell Fuller
• Shanedra Fuller
• Taneka M Fuller, LPC
• Albert Fullwood Sr.
• Marcus Jevon Fulton, NREMT-B
• Christopher Fultz, DPT
• Function First Physical Therapy, LLC
• Jacob Wade Funderburk, PLPC
• Dannette Furgerson, AGPCNP
• Ansley Fussell, MOT

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.