Active NPI
Thomas Fuller, O.D.
- Optometrist
- Asheville, NC
National Provider Identifier
1154379766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1477
- Practice address
- 2B Haw Creek LN
Asheville, NC 28805-2250 - Phone
- (828) 298-0854
- Fax
- (828) 298-2738
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1477 | NC | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 1477 | NC | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 1477 | NC |
Addresses
Primary practice location
2B Haw Creek LN
Asheville, NC 28805-2250
Mailing address
2B Haw Creek LN
Asheville, NC 28805-2250
Phone (828) 298-0854
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22-71413 | Other | NC | UNITED HEALTHCARE |
| 890907H | Medicaid | NC | |
| 0907H | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1477 | NC | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Focus Group Optometric Associates, PA | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Brevard, NC
- NPI 1194751578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1154379766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2B HAW CREEK LN",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288052250",
"telephone_number": "828-298-0854",
"fax_number": "828-298-2738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2B HAW CREEK LN",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288052250",
"telephone_number": "828-298-0854",
"fax_number": "828-298-2738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "THOMAS",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1477",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NC",
"license": "1477",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "NC",
"license": "1477",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "22-71413",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890907H",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0907H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Asheville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.