Pamela Angel Fulton, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP00616 Issued in NM

Practice address

1308 Quincy St NE
Albuquerque, NM 87110-5021

Phone

(505) 453-4727

NPI assigned

Jan 5, 2007

Last updated

Feb 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest Medical Associates, LLC

  dba Lovelace Medical Group

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment NPD
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD
• First Nations Community Health Source, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1932199171
  NPD (past)
• DHHS PHS Naihs Fort Defiance Hospital

  dba PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1942357306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 QUINCY ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105021",
            "telephone_number": "505-453-4727",
            "fax_number": "877-860-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 QUINCY ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105021",
            "telephone_number": "505-453-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "PAMELA",
        "middle_name": "ANGEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP00616",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP 00616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93708220",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janell Fuller, MD
• Lisa Fuller, LCSW
• Rowena Fuller, LCSW
• Melissa Lee Fullmer, LMT
• Adam Fulton, CSW
• Shawn Lee Fultz, M.D., J.D., M.P.H.
• Functional Aquatics Therapy
• Functional Family Medicine
• Functional Movement LLC
• Functional Orthotics & Prosthetics

• Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.