Individual provider Active NPI

Emily Fulton

  • Case Manager/Care Coordinator
  • Jacksonville, FL
National Provider Identifier
1942638283
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCM.0106468 Issued in FL
Practice address
435 Clark Rd
Jacksonville, FL 32218-5596
Phone
(904) 765-0665
NPI assigned
Oct 24, 2013
Last updated
Feb 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Case Manager/Care Coordinator 171M00000X CBHCM.0106468 FL Primary

Addresses

Primary practice location

435 Clark Rd
Jacksonville, FL 32218-5596

Mailing address

6142 Leontyne Price CT
Jacksonville, FL 32209-1824
Phone (904) 765-0665

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
CBHCM.0106468FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Highest Horizon Support Services Case Manager/Care Coordinator Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1942638283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6142 LEONTYNE PRICE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322091824",
            "telephone_number": "904-765-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 CLARK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185596",
            "telephone_number": "904-765-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM.0106468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.