KURT B. FULK, C. Ped., BOC-O, CO — NPI 1811028087 (Licensed & Credentialed Suppliers — Prosthetic

CMS-1500 Box 24J / 33a • NPI

1811028087

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

335E00000X (CMS 51)

Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier

Box 32 Service Location & ZIP+4

2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO, 65804-2534

✓ 9-Digit EDI 837 ZIP+4 (65804-2534)

Practice Phone & Referral Fax

(417) 888-0887

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1811028087 (KURT B. FULK, C. Ped., BOC-O, CO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1811028087` (NPI-1 Individual Practitioner)
Provider / Legal Name	KURT B. FULK, C. Ped., BOC-O, CO
Plain-English Specialty	Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier NUCC Code: `335E00000X` (Prosthetic/Orthotic Supplier)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO, 65804-2534
Practice Telephone / Fax	Tel: (417) 888-0887
Administrative Mailing Address	638 SOMMER LN, BILLINGS, MO, 65610-8324
Enumeration & Last Sync	Enumerated: 2007-03-08 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO, 65804-2534

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Plain-English Taxonomy & CMS Crosswalk (335E00000X)

What Does Taxonomy Code 335E00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 335E00000X translates to:
"Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 51 (Medical Supply Company with Orthotist) • CMS Code 52 (Medical Supply Company with Prosthetist) • CMS Code 53 (Medical Supply Company with Orthotist-Prosthetist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Prosthetic/Orthotic Supplier for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KURT B. FULK, C. Ped., BOC-O, CO)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`335E00000X` — Prosthetic/Orthotic Supplier Plain English: Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KURT B. FULK, C. Ped., BOC-O, CO (NPI #1811028087)