CHRISTOPHER LEIGH FULLMER
NPI 1053012831
Student in an Organized Health Care Education/Training Program in Glendale, AZ

Q: What is Christopher Fullmer's NPI number?

The NPI number for Christopher Fullmer is 1053012831. It was assigned to this individual provider in the NPPES registry on March 17, 2023.

Q: What is Christopher Fullmer's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 17, 2023PECOS Enrolled

19555 N 59TH AVE, GLENDALE, AZ 85308(653) 572-3200 Get Directions Write a Review

NPPES record last updated: March 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Christopher Leigh Fullmer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRISTOPHER LEIGH FULLMER (NPI 1053012831) is an individual student in an organized health care education/training program in Glendale, Arizona and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053012831

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameCHRISTOPHER LEIGH FULLMER

Location Address19555 N 59TH AVEGlendale, AZ 85308-6813

Mailing Address3826 W Michelle DrGlendale, AZ 85308-2719 · (385) 297-1770

Phone(653) 572-3200

Sole ProprietorYes

Enumeration DateMarch 17, 2023

NPPES CertifiedMarch 17, 2023

✔ NPI 1053012831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

19555 N 59TH AVE, Glendale, AZ 85308

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Christopher Leigh Fullmer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREW WOOD

Student in an Organized Health Care Education/Training Program