JOHN ROBERT FULTS O.D.
NPI 1083777890
Optometrist in Bloomington, IL

Q: What is John Fults's NPI number?

The NPI number for John Fults is 1083777890. It was assigned to this individual provider in the NPPES registry on December 19, 2006.

Q: What is John Fults's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for John Fults was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 19, 2006

1631 E EMPIRE ST, BLOOMINGTON, IL 61701(309) 662-4074(309) 662-4074 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About John Robert Fults O.d. NPPES

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

JOHN ROBERT FULTS O.D. (NPI 1083777890) is an individual optometrist in Bloomington, Illinois, licensed in Illinois (46-006841) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1083777890

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameJOHN ROBERT FULTSCredential: O.D.

Location Address1631 E EMPIRE STBloomington, IL 61701-3531

Mailing Address114 E Williams StBroadwell, IL 62634-6367 · (217) 732-7422

Phone(309) 662-4074

Fax(309) 662-4074

Sole ProprietorNo

Enumeration DateDecember 19, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1083777890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in IL · 46-006841

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1631 E EMPIRE ST, Bloomington, IL 61701

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Other Identifiers 1

Medicare UPIN153692IL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Fults's NPI number?

The NPI number for John Fults is 1083777890. It was assigned to this individual provider in the NPPES registry on December 19, 2006.

Where is John Fults located?

John Fults practices at 1631 E Empire St, Bloomington, IL 61701. The listed phone number is (309) 662-4074.

What is John Fults's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for John Fults was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.