Individual provider Active NPI

Cecil Fuller II, CRNA

  • Registered Nurse
  • Madison, TN
National Provider Identifier
1093478414
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-162112 Issued in AL
Practice address
315 Hospital Dr
Madison, TN 37115-5030
Phone
(615) 868-6503
NPI assigned
Oct 21, 2021
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-162112 AL
Registered Nurse 163W00000X 1-162112 AL Primary

Addresses

Primary practice location

315 Hospital Dr
Madison, TN 37115-5030

Mailing address

2024 Crencor Dr
Goodlettsville, TN 37072-4306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240827000328 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507305224 Reassigns benefits to 3 organizations
I20251013003000 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507305224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4401 River Chase Dr
Phenix City, AL 36867-7483
Phone (334) 732-3010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1-162112ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Aug 1, 2025 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2025 Accepting new patients
Vaughan Regional Anesthesia LLC CurrentSince May 27, 2024 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 14, 2025 Accepting new patients
Sylacauga Anesthesia PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

1015 Medical Center Pkwy
Selma, AL 36701
Phone (334) 418-4100

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

44 N Broadway Ave
Sylacauga, AL 35150
Phone (256) 404-5321

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071

680 S 4th St
Louisville, KY 40202
Phone (502) 596-6063

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1093478414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 CRENCOR DR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370724306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOSPITAL DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155030",
            "telephone_number": "615-868-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CECIL",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-162112",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-162112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.