Bryan H. Fuller, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35078023 Issued in OH

Practice address

1005 E Ring Rd
Ironton, OH 45638-9610

Phone

(740) 534-9830

Fax

(740) 534-9832

NPI assigned

Feb 2, 2006

Sex

Male

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 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

JC Edwards School of Medicine, Marshall University, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Merit-based Incentive Payment System (MIPS)

Final score

82.59 of 100Reported as group

Quality

59.57

Promoting interoperability

100

Improvement activities

40

Cost

71.16

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Somc Medical Care Foundation, Inc.

  • Family Medicine Physician
  • Portsmouth, OH
  • NPI 1457467227
  Medicare reassignment Care Compare group NPD
• Somc Medical Care Foundation, Inc.

  • Diagnostic Radiology Physician
  • Portsmouth, OH
  • NPI 1366686230
  NPD
• Ohio Valley Physicians Inc

  • Substance Abuse Rehabilitation Facility
  • South Point, OH
  • NPI 1750776068
  NPD (past)
• Bellefonte Physician Services, Inc.

  • Internal Medicine Physician
  • Ashland, KY
  • NPI 1811484264
  NPD (past)

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

• Southern Ohio Medical Center

  • General Acute Care Hospital
  • Portsmouth, OH
  • NPI 1053342816
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1104898592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E RING RD",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456389610",
            "telephone_number": "740-534-9830",
            "fax_number": "740-534-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRYAN",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35078023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191453",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000634705",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000653707",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000380360",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000594108",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64022601",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bryan.fuller@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1005 E Ring Rd",
            "city": "Ironton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456389610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Kay Fritz
• Fruth Pharmacy of Ohio Inc
• Fruth Pharmacy of Ohio Inc
• Abigail Madison Frye
• Doreen Fulks
• Laura J Fyffe
• G. Scott Davis, M.D., Inc.
• Kerri Elizabeth Galloway, M.S.P.T.
• Adam Gambill
• Shana Gamertsfelder

• Internal Medicine Physician in Ironton, OH
• Providers in Ironton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.