Individual provider Active NPI

Sonya Dunn Fulp, DC

  • Chiropractor
  • Tifton, GA
National Provider Identifier
1962873083
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO09592 Issued in GA
Practice address
114 12TH St W Ste F
Tifton, GA 31794-6976
Phone
(229) 402-7833
Fax
(229) 472-9055
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO09592 GA Primary

Addresses

Primary practice location

114 12TH St W Ste F
Tifton, GA 31794-6976

Mailing address

114 12TH St W Ste F
Tifton, GA 31794-6976
Phone (229) 402-7833

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fulpspinalwellness@icloud.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506002031 GA Practitioner - Chiropractic 8224337530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 12TH St W
Suite F
Tifton, GA 31794-6976
Phone (229) 402-7833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO09592GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fulp Spinal Wellness Center, LLC Chiropractor CurrentSince Feb 2, 2016 Accepting new patients

Locations

114 12th St W
Ste F
Tifton, GA 31794
Phone (229) 382-6414

1495 Kennedy Rd
Tifton, GA 31794
Phone (229) 382-5321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1962873083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 12TH ST W STE F",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317946976",
            "telephone_number": "229-402-7833",
            "fax_number": "229-472-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 12TH ST W STE F",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317946976",
            "telephone_number": "229-402-7833",
            "fax_number": "229-472-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULP",
        "first_name": "SONYA",
        "middle_name": "DUNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO09592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fulpspinalwellness@icloud.com",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "114 12th St W Ste F",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317946976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.