Gary M Fuller, RNFA

Primary specialty

Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X

License

327890 Issued in CA

Practice address

351 Hearst Ave
San Francisco, CA 94112-1348

Phone

(415) 272-2203

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  NPD (past)
• UCSF Health Community Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1174667158
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1073669495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HEARST AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121348",
            "telephone_number": "415-272-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 HEARST AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121348",
            "telephone_number": "415-272-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "CA",
            "license": "327890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "327890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Fuller Baecker, PA-C
• Fuller Smiles San Francisco Inc
• Fuller Smiles San Francisco Inc
• Ashley Fuller, RD
• Chelsea Dawn Fuller, LMFT
• Gretchen Fuller
• K'Chelle Mari Fuller, SUD
• Kendra Fuller
• Kishi Fuller, MFT
• Lauren Fuller

• Medical-Surgical Clinical Nurse Specialist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Medical-Surgical Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.