Pamela R Fuller, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

307 Issued in WY

Practice address

724 Front Street Suite 230
Evanston, WY 82930

Phone

(307) 789-6773

Fax

(307) 789-3244

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, UT2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• High Desert Psychology and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Evanston, WY
  • NPI 1194226266

  UT

  Medicare reassignment
• Novum Psychotherapy, PC

  • Psychologist
  • Salt Lake City, UT
  • NPI 1437666054
  NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053469452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 FRONT STREET SUITE 230",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "82930",
            "telephone_number": "307-789-6773",
            "fax_number": "307-789-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 FRONT STREET SUITE 230",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "82930",
            "telephone_number": "307-789-6773",
            "fax_number": "307-789-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "PAMELA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WY",
            "license": "307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Frey
• Charlotte Fry
• Crystal Dawn Fry
• Rolando Arturo Fuentes
• Adam K Fuller, PH.D.
• Lidia E Garcia
• Nena M. Germany-Greer, MA, CCC-SLP
• Colby Kim Gomez, DPT
• Alyssa Joanne Gonshorowski, LPC
• Gordon S Olsen DO PC

• Psychologist in Evanston, WY
• Providers in Evanston, WY by specialty
• Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.