SAMANTHA ELLEN FULLMER (NPI# 1265031496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265031496 |
| Entity Type | Individual |
| Full Name | SAMANTHA ELLEN FULLMER |
| Practice Address |
1305 E Butte Ave Florence AZ 85132-9221 |
| Mailing Address |
994 W Deoni Trl San Tan Valley AZ 85143-5010 |
| Practice Telephone | 5208684011 |
| Practice Fax Number | 5208688204 |
| Mailing Telephone | 4804764813 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 223113 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
1305 E BUTTE AVE |
| City | FLORENCE |
| State | AZ |
| Zip Code | 85132-9221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255566477 | State of Arizona Department of Corrections | Clinic/Center | 1305 E Butte Ave, Florence, AZ 85232 | 2009-05-18 |
| 1023670338 | Amanda Marie Carroll | Dentist | 1305 E Butte Ave, Florence, AZ 85132-9221 | 2019-07-08 |
| 1740758762 | Christa Melody Moore | Nurse Practitioner | 1305 E Butte Ave, Florence, AZ 85132-9221 | 2018-11-07 |
| 1073038824 | Dorothy Chinyere Igwe | Nurse Practitioner | 1305 E Butte Ave, Florence, AZ 85132-9221 | 2017-08-12 |
| 1194957670 | Jennifer Mandigo | Counselor | 1305 E Butte Ave, Florence, AZ 85132-9221 | 2009-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457905648 | Katherine Gastelum | Specialist/Technologist | 2700 North Anthem Way, Florence, AZ 85132 | 2019-07-26 |
| 1003309238 | Horizon Health and Wellness, Inc. | Clinic/Center | 450 W Adamsville Rd Ste B, Florence, AZ 85132 | 2018-06-12 |
| 1821594136 | Jeremiah David Johnson | Internal Medicine | 971 N. Jason Lopez Circle Bldg B, Florence, AZ 85132 | 2018-04-04 |
| 1174022990 | Nicholas Ryan Bibeau | Physical Therapist | 4374 East Butte Avenue, Florence, AZ 85132 | 2018-02-07 |
| 1598289464 | Cyrus Faramroze Austin | Dentist | 1100 Bowling Rd., Florence, AZ 85132 | 2017-08-01 |
| 1477082642 | Horizon Health and Wellness, Inc. | Clinic/Center | 450 W Adamsville Rd Ste A, Florence, AZ 85132 | 2017-06-09 |
| 1083150205 | Sanna Neff | Nurse Practitioner | 495 N Pinal Pkwy Ste 106, Florence, AZ 85132 | 2017-01-11 |
| 1114322807 | Affinity Physical Therapy, LLC | Physical Therapist | 350 S Main Street, Florence, AZ 85132 | 2014-10-24 |
| 1083018923 | Ryan William Taylor | Nurse Practitioner | 1155 N. Pinal Parkway, Central Az Detention Center, Florence, AZ 85132 | 2014-10-21 |
| 1881012755 | Carlos Lavor Weekly | Dentist | 1305 East Butte, Florence, AZ 85132 | 2014-03-28 |
| Find all providers in zip 85132 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214454 | Superior Healthcare Pllc | General Practice | 7560 Us Highway 42 Ste B, Florence, KY 41042-1908 | 2020-01-09 |
| 1952774838 | Allied Healthcare LLC | General Practice | 707 S Parker Dr, Florence, SC 29501-6062 | 2015-11-02 |
| 1013330216 | Singing River Healthcare, LLC | General Practice | 503 W College St, Florence, AL 35630-5311 | 2014-01-24 |
| 1376829135 | Ronald Arthur Backus | General Practice | 4185 W Lake Elwood Rd, Florence, WI 54121-9158 | 2011-10-25 |
| 1417991175 | Ednaliz Rodriguez | General Practice | 360 N Irby Street, Hopehealth, Florence, SC 29501 | 2006-06-15 |
| 1356905087 | Willis Wellness Group | General Practice | 1501 Heritage Ln, Florence, SC 29505-3141 | 2019-04-29 |
| 1962847582 | Shakaria Deanna Johnson | General Practice | 145 E Cheves St, Florence, SC 29506-2526 | 2013-05-09 |
| 1285890426 | Todd Frazier | General Practice | 3015 W Palmetto St, Florence, SC 29501-5935 | 2008-08-06 |
| 1649486606 | Bobby Frank King | General Practice | 501 Circular Rd, Una Box 5009, Florence, AL 35632-0001 | 2007-05-15 |
| 1154494318 | Sexton Dental Clinic | General Practice | 377 W Palmetto St, Florence, SC 29501 | 2006-11-16 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.