MR. KENNETH L FULTS (NPI# 1063588580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063588580 |
| Entity Type | Individual |
| Full Name | MR. KENNETH L FULTS |
| Credential | DO |
| Practice Address |
4295 Kinsey Dr Tyler TX 75703-1004 |
| Practice Telephone | 9035265000 |
| Practice Fax Number | 9035265006 |
| Mailing Telephone | 9035265000 |
| Mailing Fax Number | 9035265006 |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2013-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | D5384 | TX | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
D5384 | TX | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
D5384 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL WORKERS COMPENSAT | 179887500 | 01 | |
| TX | RAILRAOD MEDICARE | P00159937 | 01 |
| TX | 138804306 | 05 | |
| TX | BC BS | 00J665 | 01 |
| Street Address |
4295 KINSEY DR |
| City | TYLER |
| State | TX |
| Zip Code | 75703-1004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146794 | Janine Coles Islam | Physical Medicine & Rehabilitation | 4295 Kinsey Dr, Tyler, TX 75703-1004 | 2005-06-30 |
| 1154577641 | Healthport P.a. | Chiropractor | 4295 Kinsey Dr, Tyler, TX 75703-1004 | 2008-08-15 |
| 1407922057 | Larry R Isbell | Chiropractor | 4295 Kinsey Dr, Tyler, TX 75703-1004 | 2006-11-27 |
| 1235205881 | Isbell Chiropractic | Chiropractor | 4295 Kinsey Dr, Tyler, TX 75703-1004 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508318460 | Tyler Integrative Health and Wellness, LLC | Physical Medicine & Rehabilitation | 7062 Highlands Ln, Tyler, TX 75703 | 2016-10-26 |
| 1962567586 | Gerald P Foox | Physical Medicine & Rehabilitation | 1405 S. Fleishel Ave, Suite 316, Tyler, TX 75701 | 2006-12-26 |
| 1194817825 | Spine Specialists, Pa | Physical Medicine & Rehabilitation | 1814 Roseland Blvd., Suite 250, Tyler, TX 75701 | 2006-09-29 |
| 1487698106 | Donald Edward Arego | Physical Medicine & Rehabilitation | 701 Olympic Plaza, 2nd Floor, Tyler, TX 75701 | 2006-06-15 |
| 1952308777 | Ritesh R Prasad | Physical Medicine & Rehabilitation | 3110 Park Center Dr, Tyler, TX 75701-9215 | 2005-07-07 |
| 1336146794 | Janine Coles Islam | Physical Medicine & Rehabilitation | 4295 Kinsey Dr, Tyler, TX 75703-1004 | 2005-06-30 |
| 1538760640 | Ancelmo Mojarro | Physical Medicine & Rehabilitation | 100 E Ferguson St, Tyler, TX 75702-5759 | 2020-11-04 |
| 1336775014 | Katherine Sue Henke | Physical Medicine & Rehabilitation | 701 Olympic Plaza Cir, Tyler, TX 75701-1950 | 2020-03-13 |
| 1720510795 | Trinity Physical Medicine and Rehab, Pllc | Physical Medicine & Rehabilitation | 7062 Highlands Ln, Tyler, TX 75703-0590 | 2017-03-29 |
| 1275850836 | James Edward Applebury | Physical Medicine & Rehabilitation | 3131 Troup Hwy, Tyler, TX 75701-8350 | 2010-04-22 |
| Find all providers in TYLER | ||||
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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.