Christy Latasha Fuller, LMT

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

MT008977 Issued in GA

Practice address

2288 Miriam LN
Decatur, GA 30032-5551

Phone

(404) 343-8848

NPI assigned

Jun 27, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1063852630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 DELK RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678847",
            "telephone_number": "404-343-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 MIRIAM LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325551",
            "telephone_number": "404-343-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHRISTY",
        "middle_name": "LATASHA",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "MT008977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Frieson, PHD
• Quaye B Frietas, CRNA
• Rula G Fritz, AU.D.,
• From the Heart Enterprises, Inc
• Alana Ann Frye, MSW
• James Evans Fuller, PA-C
• Tomeka Bonshell Fuller, LPN
• NA-Ilah Imani Fulton, MA
• Susan McCarthy Furman, PH.D.
• Ga Department of Behavioral Health and Developmental Disabilities

• Exclusive Provider Organization in Decatur, GA
• Providers in Decatur, GA by specialty
• Exclusive Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.