MS. KONDRA MIA FULMER
NPI 1659304384
Counselor - Professional in Alexandria, VA

Q: What is Kondra Fulmer's NPI number?

The NPI number for Kondra Fulmer is 1659304384. It was assigned to this individual provider in the NPPES registry on July 8, 2006.

Q: What is Kondra Fulmer's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Kondra Fulmer was last updated on June 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 08, 2006PECOS EnrolledAccepts Medicare Assignment

4850 MARK CENTER DR, ALEXANDRIA, VA 22311(703) 746-3400 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Ms. Kondra Mia Fulmer NPPES

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

MS. KONDRA MIA FULMER (NPI 1659304384) is an individual professional provider in Alexandria, Virginia, licensed in Virginia (0701006170) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Prince Frederick, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1659304384

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMS. KONDRA MIA FULMER

Location Address4850 MARK CENTER DRAlexandria, VA 22311-1882

Mailing Address975 N Selomons Island, Po Box 980Prince Frederick, MD 20678 · (410) 535-5400 · Fax (410) 414-9413

Phone(703) 746-3400

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateJuly 8, 2006

Last NPPES UpdateJune 20, 2024

NPPES CertifiedJune 20, 2024

✔ NPI 1659304384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in VA · 0701006170

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LC2175 (MD)

4850 MARK CENTER DR, Alexandria, VA 22311

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Secondary Practice Location 1

Location 1975 N Selomons IslandPrince Frederick, MD 20678 · Phone (410) 535-5400 ext. 475 · Fax (410) 414-9413

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

Ms. Kondra Mia Fulmer 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 ID7517309594

PECOS Enrollment IDI20250207003381

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.

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.

JENNIFER VASQUEZ LMHP-S

Social Worker (Clinical)