NPIMap

Organization Active NPI

Shelia a. Fuller, O.D., L.L.C

  • Optometrist
  • Ontario, OH
National Provider Identifier
1043578875
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901-T1771 Issued in OH
Legal business name
SHELIA A. FULLER, O.D., L.L.C
Practice address
339 N Lexington Springmill Rd
Ontario, OH 44906-1218
Phone
(419) 525-2060
Fax
(419) 529-9060
NPI assigned
Apr 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Authorized official

Name
Shelia Fuller
Title
President
Phone
(419) 525-2060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901-T1771 OH Primary

Addresses

Primary practice location

339 N Lexington Springmill Rd
Ontario, OH 44906-1218

Mailing address

339 N Lexington Springmill Rd
Ontario, OH 44906-1218
Phone (419) 525-2060

Other names 1

  • Shelia Fuller OD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1043578875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 N LEXINGTON SPRINGMILL RD",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061218",
            "telephone_number": "419-525-2060",
            "fax_number": "419-529-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 N LEXINGTON SPRINGMILL RD",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061218",
            "telephone_number": "419-525-2060",
            "fax_number": "419-529-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELIA A. FULLER, O.D., L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-525-2060"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4901-T1771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelia Fuller OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.