Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chad B Fullmer, MPT

Individual provider Physical Therapist · NPI 1285760033

Chad B Fullmer, MPT is a Physical Therapist in Private Practice in Provo, Utah. Qualified in 2000, 26 years ago. Practices with Independence Rehab LLC, a 26-clinician group and accepts Medicare assignment. Licensed in Utah and Washington.

Years since qualifying
26
Licensed in
UT, WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

5314 River Run Dr
Provo, UT 84604-5691
Phone: (801) 426-4905
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 4877705-2401 (UT)
Physical Therapist Taxonomy 225100000X · Licence PT00010369 (WA)

Record details

NPI number1285760033
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorNo
NPI enumeratedFebruary 26, 2007
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024
Mailing address434 E Three Falls Dr, Alpine, UT 84004-1296

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Independence Rehab Llc — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Provo