Vicky Joy Fuller, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209-016099 Issued in IL

Practice address

1285 Franciscan Dr
Litchfield, IL 62056-1778

Phone

(217) 324-6127

Fax

(217) 324-4522

NPI assigned

Jun 28, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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.

• Litchfield Family Practice Center

  • Family Medicine Physician
  • Litchfield, IL
  • NPI 1235189499
  Medicare reassignment NPD
• Litchfield Family Practice Center

  • Family Medicine Physician
  • Litchfield, IL
  • NPI 1083975502
  NPD

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215458484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 FRANCISCAN DR",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561778",
            "telephone_number": "217-324-6127",
            "fax_number": "217-324-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 FRANCISCAN DR",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561778",
            "telephone_number": "217-324-6127",
            "fax_number": "217-324-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "VICKY",
        "middle_name": "JOY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-016099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209-016099",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evergreen Litchfield, L.P. (Evergreen Place of Litchfield Supportive Living)
• Family Eye Care Association, P.C.
• Family Health and Wellness Chiropractic
• Amy Elaine Fisher, MD
• Suzanne Melanie Fleming, RPH
• Elise Griffith
• Corrina G Griffiths, LCPC
• Jennifer M Gudgel, APRN
• Kristin Hagopian, PMHNP-BC
• Kelley Lee Halliburton, A.T.C., P.T.A.

• Family Nurse Practitioner in Litchfield, IL
• Providers in Litchfield, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.