Shannon Ingram Fulmer, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

151514 Issued in NC

Practice address

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Phone

(919) 784-3034

NPI assigned

Jan 24, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Anesthesiology of North Carolina PLLCGroup PAC ID 2961316450, 315 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Betsy Johnson Regional Hospital Hospital, Dunn, NC, CCN 340071

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• American Anesthesiology of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Burlington, NC
  • NPI 1053677195

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Bladen Healthcare LLC

  • Critical Access Hospital
  • Elizabethtown, NC
  • NPI 1558537282
  Medicare reassignment NPD
• Southeast Anesthesiology Consultants, PLLC

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1538124201
  Medicare reassignment NPD
• Wayne Memorial Hospital Inc

  • General Acute Care Hospital
  • Goldsboro, NC
  • NPI 1750353462
  Medicare reassignment NPD
• American Anesthesiology of North Carolina, PLLC

  • Anesthesiology Physician
  • Wilmington, NC
  • NPI 1033412267
  NPD
• Bladen Healthcare LLC

  • Rural Health Clinic/Center
  • Elizabethtown, NC
  • NPI 1114269677
  NPD
• Bladen Healthcare LLC

  • Rural Health Clinic/Center
  • Whiteville, NC
  • NPI 1821764390
  NPD
• Raleigh Medical Group, PA

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1104962315
  NPD
• Southeast Anesthesiology Consultants, PLLC

  • Anesthesiology Physician
  • Wilmington, NC
  • NPI 1932402195
  NPD
• Wayne Health Physicians

  • Clinic/Center
  • Goldsboro, NC
  • NPI 1396978169
  NPD
• Wayne Memorial Hospital Inc

  • Psychiatric Hospital Unit
  • Goldsboro, NC
  • NPI 1215105713
  NPD
• Anesthesia Resources of the Carolinas, P.a.

  • Pain Medicine (Anesthesiology) Physician
  • Dunn, NC
  • NPI 1336185974
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Harnett Health System, Inc.

  • General Acute Care Hospital
  • Dunn, NC
  • NPI 1922144757
  Care Compare affiliation

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1073668893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18139",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276198139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "SHANNON",
        "middle_name": "INGRAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "151514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "430058284",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051357",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christi Fuller, LCMHCA
• Elizabeth Fuller, PA
• Ryan Chandler Fuller
• Charisse N Fullwood, PMHNP-BC
• Nyasha Fullwood
• Ebony Fulmore
• Britney Shea Fulp, LCSW
• Amanda Fultineer, DPT
• Amber Fulton
• Cynthia Heintz Fulton, AGNP-C

• Certified Registered Nurse Anesthetist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.