Susan A Fuller, DNP, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200909 Issued in NC

Practice address

300 Mack Rd
Asheboro, NC 27205-1066

Phone

(336) 625-1172

Fax

(336) 625-6434

NPI assigned

Nov 22, 2006

Last updated

Sep 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Medicare reassignment NPD
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  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1013082288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272042005",
            "telephone_number": "336-625-1172",
            "fax_number": "336-625-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MACK RD",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272051066",
            "telephone_number": "336-625-1172",
            "fax_number": "336-625-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5405 Frieden Church Road",
            "address_purpose": "LOCATION",
            "city": "McLeansville",
            "state": "NC",
            "postal_code": "27301",
            "country_code": "US",
            "telephone_number": "336-697-1550",
            "fax_number": "336-697-1580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003515",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista L Frazier, MPT
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• Victoria G Fulton, DDS
• Craig Stephen Gaccione, M.D.
• Marion Louise Gaddy, PHLEBOTOMY
• Wanda McCain Gaines, LPC
• Noelle Gaither, NP

• Nurse Practitioner in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.