NPIMap

Organization Active NPI

Stanley Fuller

  • Adult Care Home Facility
  • Fremont, OH
National Provider Identifier
1073795423
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
PN 102037 Issued in OH
Legal business name
STANLEY FULLER
Practice address
117 N Wayne St
Fremont, OH 43420-2431
Phone
(419) 307-2984
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Mr. Stanley B FullerNPI 1639344344
Title
LPN
Phone
(419) 307-2984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X PN 102037 OH Primary

Addresses

Primary practice location

117 N Wayne St
Fremont, OH 43420-2431

Mailing address

117 N Wayne St
Fremont, OH 43420-2431
Phone (419) 307-2984

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": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1073795423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N WAYNE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202431",
            "telephone_number": "419-307-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N WAYNE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202431",
            "telephone_number": "419-307-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY FULLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "419-307-2984",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "PN 102037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.