Individual provider Active NPI

Gregory Kyle Fulton, M.D.

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1972845030
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
301258 Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-2143
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 301258 LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160511002697 LA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2163711318 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
301258LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Med in New Orleans Faculty Grou Pediatrics CurrentSince Jun 1, 2016 Accepting new patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Jan 22, 2022 Accepting new patients
Children'S Hospital Pediatrics CurrentSince Mar 1, 2018 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2017 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2017 Accepting new patients
Children'S Hospital CurrentSince Mar 1, 2018 Accepting new patients
Lsuhsc New Orleans Physicians Pediatrics Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

5625 Loyola Ave
New Orleans, LA 70115
Phone (504) 359-1131

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

4000 Cadillac St
New Orleans, LA 70122
Phone (504) 324-7600

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

Organizations & group practices 7

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1972845030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "GREGORY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "301258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.