SAMANTHA JO FULLERTON OTR/L
NPI 1669724670
Occupational Therapist in Joplin, MO

Active since October 15, 2012Accepts Medicare Assignment
2218 W 32ND ST, JOPLIN, MO 64804(417) 623-5264 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Samantha Jo Fullerton Otr/l NPPES

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

SAMANTHA JO FULLERTON OTR/L (NPI 1669724670) is an individual occupational therapist in Joplin, Missouri, licensed in Missouri (2018009632) and active in the NPI registry since October 2012. She is a graduate of Other (2012).

NPPES Registry Identity

NPI1669724670
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameSAMANTHA JO FULLERTONCredential: OTR/L
Location Address2218 W 32ND STJoplin, MO 64804-3514
Mailing Address1808 New Hampshire AveJoplin, MO 64804-0953 · (417) 392-9327
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 15, 2012
Last NPPES UpdateAugust 5, 2025
NPPES CertifiedJuly 22, 2025
✔ NPI 1669724670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Licenses✔ Licensed in MO · 2018009632✔ Licensed in TX · 115050
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
2218 W 32ND ST, Joplin, MO 64804

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Jo Fullerton Otr/l 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 ID7810495330
PECOS Enrollment IDI20250813000678

Medicare Billing Reassignment

Medicare enrollment records show Samantha Fullerton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
201 S NORTHPARK LN
Joplin, MO 64801
  • Reassigned Medicare billing, Missouri enrollment
  • 34 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

Skilled Nursing Facility
2218 W 32ND ST
JOPLIN, MO 64804
Nurse Practitioner (Family)
2218 W 32ND ST
JOPLIN, MO 64804
Nurse Practitioner
2218 W 32ND ST
JOPLIN, MO 64804
Nurse Practitioner
2218 W 32ND ST
JOPLIN, MO 64804
Skilled Nursing Facility
2218 W 32ND ST
JOPLIN, MO 64804

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 Samantha Fullerton's NPI number?

The NPI number for Samantha Fullerton is 1669724670. It was assigned to this individual provider in the NPPES registry on October 15, 2012.

Where is Samantha Fullerton located?

Samantha Fullerton practices at 2218 W 32nd St, Joplin, MO 64804. The listed phone number is (417) 623-5264.

What is Samantha Fullerton's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Samantha Fullerton enrolled in Medicare?

Yes. Samantha Fullerton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Samantha Fullerton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Fullerton reassigns Medicare benefits to Aegis Group Practice LLC (Joplin, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Fullerton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Fullerton was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.