BRANDIE FULBRIGHT (NPI# 1811443179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811443179 |
| Entity Type | Individual |
| Full Name | BRANDIE FULBRIGHT |
| Practice Address |
5322 22nd St Lubbock TX 79407-2117 |
| Mailing Address |
5322 22nd Street Lubbock TX 79407 |
| Practice Telephone | 2102687759 |
| Mailing Telephone | 2102687759 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 007350 | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 007350 | 05 |
| Street Address |
5322 22ND ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79407-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609136944 | James E. Ryan | Intermediate Care Facility, Mental Illness | 5322 22nd St, Lubbock, TX 79407-2117 | 2012-05-21 |
| 1932512043 | Eugene S Bonds Jr. | Intermediate Care Facility, Mentally Retarded | 5322 22nd St, Lubbock, TX 79407-2117 | 2014-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155731 | Bryce Olson Pt, LLC | Physical Therapist | 6014 45th St Ste C Lubbock, Tx 79407, 6014 45th St Ste C Lubbock, Tx 79407, Lubbock, TX 79407 | 2020-05-07 |
| 1235762923 | Fnu Sindhuja Gunasekaran | Physical Therapist | 6014 45th Street, Lubbock, TX 79407 | 2020-02-20 |
| 1770987554 | Amanda Moore | Occupational Therapist | 6548 43rd St, Lubbock, TX 79407 | 2014-10-22 |
| 1336565639 | Best Eye Visioncare, Pllc | Optometrist | 6020 34th Street, Lubbock, TX 79407 | 2014-03-11 |
| 1003249210 | Costco Wholesale Corporation | Pharmacy | 6020 34th St, Lubbock, TX 79407 | 2013-08-12 |
| 1225304686 | Community Health Center of Lubbock, Inc. | Clinic/Center | 5424 19th St Ste 200, Lubbock, TX 79407 | 2012-03-29 |
| 1023385879 | Medway Medical Equipment IIi LLC | Durable Medical Equipment & Medical Supplies | 3448 W Loop 289, Lubbock, TX 79407 | 2011-11-22 |
| 1801102553 | Jennifer Hobbs Williams | Nurse Practitioner | 1910 Quaker Ave Ste 101, Lubbock, TX 79407 | 2010-08-19 |
| 1780901496 | Joni Rodriguez | Counselor | 1611 Ave K, Lubbock, TX 79407 | 2010-04-21 |
| 1073776860 | Southwest Regional PCr, LLC | Clinical Medical Laboratory | 2002 W Loop 289 Ste 116, Lubbock, TX 79407 | 2008-07-02 |
| Find all providers in zip 79407 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598305435 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 5814 6th St, Lubbock, TX 79416-4116 | 2020-01-08 |
| 1962042895 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 3419 54th St, Lubbock, TX 79413-4049 | 2020-01-08 |
| 1871133702 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 3425 Grinnell St, Lubbock, TX 79415-1552 | 2020-01-08 |
| 1316350507 | Mae Services LLC | Intermediate Care Facility, Mentally Retarded | 5423 23rd St, Lubbock, TX 79407-2124 | 2014-06-05 |
| 1639386865 | Lubbock Regional Mhmr Center | Intermediate Care Facility, Mentally Retarded | 3105 29th St, Lubbock, TX 79410-3022 | 2007-05-17 |
| 1396952537 | Lubbock Regional Mhmr Center | Intermediate Care Facility, Mentally Retarded | 6302 34th St, Lubbock, TX 79407-2838 | 2007-05-17 |
| 1881801827 | Lubbock Regional Mhmr Center | Intermediate Care Facility, Mentally Retarded | 6306 34th St, Lubbock, TX 79407-2838 | 2007-05-17 |
| 1972710911 | Lubbock Regional Mhmr Center | Intermediate Care Facility, Mentally Retarded | 8405 19th St, Lubbock, TX 79407-3900 | 2007-05-17 |
| 1649484817 | Westview Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 3412 85th St, Lubbock, TX 79423-2621 | 2007-05-09 |
| 1164640488 | Calab, Inc. | Intermediate Care Facility, Mentally Retarded | 2503 Ash Ave, Lubbock, TX 79404-1621 | 2007-04-23 |
| Find all providers in LUBBOCK | ||||
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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.