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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 9415721-1204 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
5121 S COTTONWOOD ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-5701 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| 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. |
| 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 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
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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.