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Dr. Mark Allen Fullmer , MD

Surgery β€’ Provo, UT

Active NPI 1457420853 Individual Practitioner Male Practitioner
Practice location in NPPES

1055 N 300 W, Suite 418
Provo, UT 846043344

Call 8013577100 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1055 N 300 W
Suite 418

Provo, UT 846043344

Telephone 8013577100
Fax 8013578100
Organization at the Same NPPES Address or Phone
Intermountain Healthcare Facility NPI 1326096728

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $25.46 in 2023

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2023.

Guide: How to read an Open Payments record

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Provo and Utah

18 active clinicians are listed under Surgery with a practice address in Provo, UT (260 in Utah).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Provo

5.6% of these 18 clinicians have the CMS telehealth indicator.

38.9% of these 18 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2023
Disclosure Year:

Program year 2023 (payments made January 1 – December 31, 2023): fewer than 11 records totaling $25.46.

Manufacturer Payment Nature Product Type Amount ($)
Boston Scientific Corporation
Food and Beverage
In-kind items and services
β€” General $25.46

Source: CMS Open Payments, program year 2023, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-05-16
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

License # reported to NPPES UT 152450-1205

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Utah Division of Professional Licensing.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Max Mcbride , PhD

Psychologist - Clinical

NPI 1083793467

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Business Mailing Address May 16, 2021

Registered at 1512 RENAISSANCE TOWNE DR STE 200, BOUNTIFUL, UT 840107517 (Tel: 3852042722)

βœ…
NPI Profile Active July 17, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 17, 2012

Registered at 1055 N 300 W, SUITE 418, PROVO, UT 846043344 (Tel: 8013577100)

πŸ“
Business Mailing Address (Initial Record) July 17, 2012

Registered at 1055 N 300 W, SUITE 418, PROVO, UT 846043344 (Tel: 8013577100)

πŸ‘€
Provider Name / Credentials (Initial Record) July 17, 2012

Recorded as MARK FULLMER, M.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2012

Surgery (license number reported to NPPES: UT 152450-1205)

🟒
Initial NPI Registration & Enumeration November 07, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1457420853
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2006
Last Update: March 07, 2023
Sole Proprietor: Yes

Other Surgery Specialists in Provo

All Surgery Specialists in Provo

Mailing Address

1512 Renaissance Towne Dr Ste 200

Bountiful, UT 840107517

Phone: 3852042722

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.