Daniel Richards Fullmer, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD00049079 Issued in WA

Practice address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

Mar 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 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in TN, UT, TX, MT4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

University of Utah School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Donalsonville Hospital IncGroup PAC ID 7113919820, 63 clinicians

Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians

Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Virtual Radiologic Professionals LLCGroup PAC ID 4981608817, 392 clinicians

Fred Smeltzer MD and Associates IncGroup PAC ID 8921078304, 95 clinicians

North Georgia RadiologyGroup PAC ID 9032103296, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
• Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007
• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161
• Tristar Skyline Medical Center Hospital, Nashville, TN, CCN 440006
• Abbeville Area Medical Center Hospital, Abbeville, SC, CCN 421301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Donalsonville Hospital Inc

  • Rural Acute Care Hospital
  • Donalsonville, GA
  • NPI 1720095805

  UT

  Medicare reassignment Care Compare group NPD
• Fred Smeltzer MD & Associates Inc

  • Diagnostic Radiology Physician
  • Osage Beach, MO
  • NPI 1639122286

  UT

  Medicare reassignment Care Compare group NPD
• North Georgia Radiology

  • Specialist
  • Dalton, GA
  • NPI 1922193044

  UT

  Medicare reassignment Care Compare group NPD
• Northside Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1013960657

  UT

  Medicare reassignment Care Compare group NPD
• Radiology Alliance PC

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1861478489

  UT

  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology, UT

  Medicare reassignment Care Compare group NPD
• Virtual Radiologic Professionals, LLC

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1932342029

  UT

  Medicare reassignment Care Compare group NPD
• Central Montana Medical Facilities, Inc

  • Critical Access Hospital
  • Lewistown, MT
  • NPI 1790798387
  Medicare reassignment NPD
• Radiology Specialists LTD Marasso-Miller

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1437196979

  UT

  Medicare reassignment NPD
• Sidney Health Center

  • Critical Access Hospital
  • Sidney, MT
  • NPI 1285719161
  Medicare reassignment NPD
• Ton San Simon Health Center

  • Health Service Clinic/Center
  • Sells, AZ
  • NPI 1588834998

  TX

  Medicare reassignment NPD
• Ton San Xavier Health Center

  • Federal Public Health Clinic/Center
  • Tucson, AZ
  • NPI 1437157302

  TX

  Medicare reassignment NPD

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

• Abbeville County Memorial Hospital

  • Critical Access Hospital
  • Abbeville, SC
  • NPI 1063449361
  Care Compare affiliation
• Abbeville County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Abbeville, SC
  • NPI 1811096423
  Care Compare affiliation
• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation
• Hti Memorial Hospital Corporation

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1295780476
  Care Compare affiliation
• Phoebe Putney Memorial Hospital Inc

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Care Compare affiliation
• Self Regional Healthcare

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, SC
  • NPI 1013867498

  Hospital

  Care Compare affiliation
• Self Regional Healthcare

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1023046612
  Care Compare affiliation
• Self Regional Healthcare

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1407887003
  Care Compare affiliation
• Self Regional Healthcare

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
  • NPI 1720938103

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1114994738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Minnesota Dr Ste 800",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554357915",
            "country_code": "US",
            "telephone_number": "952-595-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "DANIEL",
        "middle_name": "RICHARDS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-12249",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00049079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA REST OF WA",
            "identifier": "0285030",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SWEDISH RADIA EDMONDS",
            "identifier": "0377766",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114994738",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054630",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4019715",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA KING COUNTY",
            "identifier": "0377759",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4102721",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M'Lyss Maree Fruhling, M.A.
• Shelbie Frye
• Aaron Yiu-Kai Fu, MD
• Musetta Chang-CHI Fu, ARNP
• Full of Hope Adult Family Home LLC
• Collin Mathieu Funfschilling
• Anika Ashlyn Fung
• Jennie Gabrielson
• Andrea Latrice Gadson
• Michael Gain

• Diagnostic Radiology Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.