CONNOR MICHAEL FULLERTON MD
NPI 1114667698
Student in an Organized Health Care Education/Training Program in Gainesville, FL
About Connor Michael Fullerton Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CONNOR MICHAEL FULLERTON MD (NPI 1114667698) is an individual student in an organized health care education/training program in Gainesville, Florida and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Connor Michael Fullerton Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
GAINESVILLE, FL 32610
GAINESVILLE, FL 32610
GAINESVILLE, FL 32610
GAINESVILLE, FL 32610
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 Connor Fullerton's NPI number?
The NPI number for Connor Fullerton is 1114667698. It was assigned to this individual provider in the NPPES registry on March 31, 2022.
Where is Connor Fullerton located?
Connor Fullerton practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-0076.
What is Connor Fullerton's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Connor Fullerton enrolled in Medicare?
Yes. Connor Fullerton is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Connor Fullerton was last updated on June 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Connor Michael Fullerton, MD · NPI 1114667698
Student in an Organized Health Care Education/Training Program provider in Gainesville, Florida. Individual provider, active in the CMS NPPES registry since March 31, 2022.
## Identity
- **NPI:** 1114667698 (Entity type: Individual)
- **Enumerated:** March 31, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1600 SW ARCHER RD, Gainesville, FL 32610-3003
- **Phone:** (352) 265-0076
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 1, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1114667698) · Data from the CMS NPPES public registry.