Individual provider Active NPI

June Williams Fuller

  • Prosthetics Case Management
  • Humble, TX
National Provider Identifier
1013555739
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
670251 Issued in TX
Practice address
15703 Cairnwell Bend Dr
Humble, TX 77346-4361
Phone
(832) 264-5293
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Prosthetics Case Management 1744P3200X 670251 TX Primary

Addresses

Primary practice location

15703 Cairnwell Bend Dr
Humble, TX 77346-4361

Mailing address

PO Box 2063
Humble, TX 77347-2063
Phone (832) 264-5293

Other practice location 1

16770 Imperial Valley Dr Ste 125E
Houston, TX 77060-3427
Phone (832) 264-5293

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL JFULL.Beauty@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
670251TXMDProsthetics Case Management

Practice roles

OrganizationSpecialtyStatusNew patients
Strategic Development & Instruction Mental Health CurrentSince Dec 15, 2019 Accepting new patients
Strategic Development & Instruction Current Accepting new patients
Sagacious Beauty LLC. Mental Health CurrentSince Jul 31, 2023 Accepting new patients

Locations

16770 Imperial Valley Dr
Ste 125E
Houston, TX 77060
Phone (713) 240-3946

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1013555739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2063",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773472063",
            "telephone_number": "832-264-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15703 CAIRNWELL BEND DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773464361",
            "telephone_number": "832-264-5293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16770 Imperial Valley Dr Ste 125E",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770603427",
            "country_code": "US",
            "telephone_number": "832-264-5293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JUNE",
        "middle_name": "WILLIAMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": "670251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JFULL.Beauty@gmail.com",
            "affiliation": "N",
            "address_1": "16843 Ellicott Rock Dr",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773464206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.