CLARK J FULLMER II DPM
NPI 1649240557
Podiatrist - Foot & Ankle Surgery in Dickinson, ND

Q: What is Clark Fullmer's NPI number?

The NPI number for Clark Fullmer is 1649240557. It was assigned to this individual provider in the NPPES registry on January 24, 2006.

Q: What is Clark Fullmer's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Q: When was this NPI record last updated?

The NPPES record for Clark Fullmer was last updated on August 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 January 24, 2006PECOS EnrolledAccepts Medicare Assignment

83.98/100

CMS Quality Rating

2615 FAIRWAY ST, DICKINSON, ND 58601(701) 456-6000 Get Directions Write a Review

NPPES record last updated: August 30, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Clark J Fullmer Ii Dpm NPPES

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

CLARK J FULLMER II DPM (NPI 1649240557) is an individual foot & ankle surgery provider in Dickinson, North Dakota, licensed in North Dakota (60) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Sanford Medical Center Bismarck, and is a graduate of California School Of Podiatric Medicine (1995).

NPPES Registry Identity

NPI1649240557

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameCLARK J FULLMER IICredential: DPM

Location Address2615 FAIRWAY STDickinson, ND 58601

Mailing Address2615 Fairway StDickinson, ND 58601-2590 · (701) 456-6000

Phone(701) 456-6000

Sole ProprietorNo

Medical School CMSCalifornia School Of Podiatric MedicineGraduated 1995

Enumeration DateJanuary 24, 2006

Last NPPES UpdateAugust 30, 2018

✔ NPI 1649240557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in ND · 60

2615 FAIRWAY ST, Dickinson, ND 58601

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Other Identifiers 1

Medicaid14953ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Clark J Fullmer Ii Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981708567

PECOS Enrollment IDI20100127000303

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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

188 services28 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

128 services91 patients

Trimming of dystrophic nails, any number G0127

Trimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.

106 services45 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

99 services42 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

79 services79 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

58 services40 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Medical Center Bismarck

Acute Care Hospitals · Bismarck, ND

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number350015

Location300 N 7th StBismarck, ND 58506 · Burleigh County

Emergency services Birthing friendly

Mckenzie County Healthcare Systems Inc

Critical Access Hospitals · Watford City, ND

OwnershipVoluntary non-profit - Private

CMS Certification Number351302

Location709 4th Ave NEWatford City, ND 58854 · Mckenzie County

Emergency services

Chi St Alexius Health Dickinson

Critical Access Hospitals · Dickinson, ND

OwnershipVoluntary non-profit - Church

CMS Certification Number351336

Location2500 Fairway StreetDickinson, ND 58601 · Stark County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.98/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.28

Promoting Interoperability

Improvement Activities

Cost

68.15

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf L4387

DME-Orthotic Devices · category DF000N

1 supplier11 claims11 services$133.68 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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