Chuck B Fuller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-499 Issued in ID

Practice address

660 Shoshone St E
Suite 130
Twin Falls, ID 83301-6110

Phone

(208) 732-3400

Fax

(208) 732-3300

NPI assigned

Oct 4, 2005

Last updated

Jan 10, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sterling Provider GroupGroup PAC ID 2264773373, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sterling Provider Group

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1205300407
  Medicare reassignment Care Compare group
• Falls Avenue Immediate Care PA

  • Primary Care Clinic/Center
  • Twin Falls, ID
  • NPI 1912481292
  NPD
• Page Family Medicine

  • Family Medicine Physician
  • Burley, ID
  • NPI 1487151882
  NPD (past)
• Psychiatric Services Behavioral Health Clinic Inc

  dba Psbhc

  • Community/Behavioral Health Agency
  • Twin Falls, ID
  • NPI 1013204957
  NPD (past)
• Psychiatric Services, PA

  • Psychiatry Physician
  • Twin Falls, ID
  • NPI 1528136793
  NPD (past)
• St Luke's Magic Valley Regional Medical Center LTD

  dba St Lukes Retail Pharmacy Twin Falls

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1124015102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 SHOSHONE ST E",
            "address_2": "SUITE 130",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016110",
            "telephone_number": "208-732-3400",
            "fax_number": "208-732-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SHOSHONE ST E",
            "address_2": "SUITE 130",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016110",
            "telephone_number": "208-732-3400",
            "fax_number": "208-732-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHUCK",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Fry, M.A. L/C.P.C. Q.P.
• Barbara Jane Fuchs, RPH
• Daniel Scott Fuchs, RPH
• Edward L Fuchs
• Brooke Marie-Osgood Fukuoka
• Jennie Rebecca Fullmer, LPC
• Shawna Fultz, LMSW
• Chase A Funk, DDS
• Spencer Funk, DO
• G Adrian Dean MD Inc

• Physician Assistant in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.