DR. JACE PAUL FULLMER


Address: 5121 S Cottonwood St, Salt Lake City, UT 84107-5701
Phone: 8015079700

DR. JACE PAUL FULLMER (NPI# 1306145776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306145776
Entity Type Individual
Full Name DR. JACE PAUL FULLMER
Credential D.O.
Practice Address 5121 S Cottonwood St
Salt Lake City
UT 84107-5701
Practice Telephone 8015079700
Enumeration Date 2011-03-23
Last Update Date 2015-12-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207P00000X Emergency Medicine 9415721-1204 UT Allopathic & Osteopathic Physicians

Office Location

Street Address 5121 S COTTONWOOD ST
City SALT LAKE CITY
State UT
Zip Code 84107-5701

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811544604 Angela Hall Birkeland Nurse Practitioner 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2019-08-26
1720545585 Alessa Wade Dietitian, Registered 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2019-02-27
1003366766 Anastasiya Mankouski Pediatrics 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2016-10-06
1437503091 Matthew Neil Lamont Hospitalist 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2016-04-20
1588048979 Utah Emergency Physicians Emergency Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2015-07-15
1740608686 Stephanie Aileen Chan Internal Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2014-03-28
1225471816 Jason Edward Allen Internal Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2013-04-12
1760825822 Jeffrey Leonard Halleck Internal Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2013-04-09
1356609317 Lana Joelle Mcgill Internal Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2012-04-27
1013293620 Jared David Miller Internal Medicine 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 2011-10-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902410517 Brielle Nicole Poulter Student in an Organized Health Care Education/Training Program 345 East 4500 So #260, Murray, UT 84107 2020-09-01
1467016592 Ashlee Brown Social Worker C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 2019-04-24
1568940633 Samantha Duff Occupational Therapist 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 2018-08-01
1881185247 Derek John Sharp Occupational Therapist 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 2018-05-22
1093223091 Erin Nicole Hill Counselor 345 East 4500 South Suite 260, Murray, UT 84107 2018-01-12
1588171219 Nicole Danielle Jensen Counselor 345 East 4500 South, Suite 260, Murray, UT 84107 2018-01-03
1043725799 Greater Endodontics LLC Dentist 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 2017-12-04
1043739667 Karyn K Hodge Audiologist 4500 So. 777. E. Ste #110, Murray, UT 84107 2017-09-14
1912426750 Brandon C Burton Specialist/Technologist, Other Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 2017-09-13
1396261152 Megan Lehane Delano Plastic Surgery 5169 Cottonwood St Ste 420, Murray, UT 84107 2017-08-14
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Taxonomy Information

Taxonomy Code 207P00000X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine

Taxonomy Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source]
- Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700414216 True North Health Navigation LLC Emergency Medicine 136 E South Temple Ste 1400, Salt Lake City, UT 84111-1143 2020-03-30
1609377589 David A. Burton Emergency Medicine 1040 S Oak Hills Way, Salt Lake City, UT 84108-2024 2018-02-26
1184131922 Wally Lee Emergency Medicine 3539 E Brighton Point Dr, Salt Lake City, UT 84121-5510 2018-01-02
1295240026 Allison Mcphee Emergency Medicine 1021 E 3300 S, Salt Lake City, UT 84106-2142 2017-12-01
1104351592 David Crockett Emergency Medicine University of Utah School of Medicine 30 N 1900 E 1c026, Salt Lake City, UT 84132-2147 2017-04-24
1699160598 Sean Damian Slack Emergency Medicine Division of Emergency Medicine School Of, 30 N 1900 E 1c026, Salt Lake City, UT 84132-0001 2015-03-30
1801201496 Dwight Burdick Emergency Medicine 2665 E 2100 S, Salt Lake City, UT 84109-1372 2014-06-23
1467872358 Anna Rudolphi Emergency Medicine 30 N 1900 E 1c026, Division of Emergency Medicine- University of Utah, Salt Lake City, UT 84132 2014-04-18
1598004087 Alison L Smith Emergency Medicine 764 E Hawthorne Ave, Salt Lake City, UT 84102 2013-02-04
1205195229 Brian Galovic Emergency Medicine University of Utah Hospital Emergency, 50 North Medical Drive, Salt Lake City, UT 84132-0001 2012-05-11
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Competitor

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City SALT LAKE CITY
Zip Code 84107

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Dataset Information

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.

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