Nathanael Keith Fuller, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002297 Issued in IA

Practice address

1550 6TH Street
Manning, IA 51455-1004

Phone

(712) 655-2072

Fax

(712) 655-3228

NPI assigned

Jun 21, 2012

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 IA

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint at Home Home health agency, Urbandale, IA, CCN 167148

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfuller433452@direct.unitypoint.org

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  IA

  Medicare reassignment Care Compare group NPD
• Iowa Physicians Clinic Medical Foundation

  • Clinical Medical Laboratory
  • Cedar Falls, IA
  • NPI 1538617840
  Care Compare group
• Iowa Physicians Clinic Medical Foundation

  • Rural Health Clinic/Center
  • Kingsley, IA
  • NPI 1659263523

  Physician Assistant

  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Unitypoint at Home

  • Home Health Agency
  • West Des Moines, IA
  • NPI 1194753863
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1144583451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 6TH ST",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551005",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 6TH STREET",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551004",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NATHANAEL",
        "middle_name": "KEITH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Char-Mac of Manning
• Daren Danielson, TCADC
• Nancy L Danner, P.A.-C.
• Jaime Ann England, PT
• Melissa Frazier, ARNP
• Higher Up Chiropractic
• Hope Beyond the Stables
• Neeka Ann Jacobsen, IADC
• Kati Mari Jones
• Michelle Marie Kroeger, ARNP, MSN

• All providers in Manning, IA
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.