Individual provider Active NPI

James C Fuselier, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
National Provider Identifier
1174595664
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
17190 Issued in TX
Practice address
2501 W William Cannon Dr
Suite 6B
Austin, TX 78745-5281
Phone
(512) 447-6684
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 17190 TX Primary

Addresses

Primary practice location

2501 W William Cannon Dr
Suite 6B
Austin, TX 78745-5281

Mailing address

711 W 38TH St
Suite a-1
Austin, TX 78705-1121
Phone (512) 454-1220

Other identifiers 1

IdentifierTypeStateIssuer
K2964OtherTXMEDICAL LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 23, 2024 through Jan 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17190TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1174595664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 38TH ST",
            "address_2": "SUITE A-1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051121",
            "telephone_number": "512-454-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W WILLIAM CANNON DR",
            "address_2": "SUITE 6B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455281",
            "telephone_number": "512-447-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSELIER",
        "first_name": "JAMES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS  MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "17190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "K2964",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.