Individual provider Active NPI

Ronald Keith Fuller Jr., AG-ACNP

  • Acute Care Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1225493646
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN176821 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2212
Phone
(404) 686-2271
NPI assigned
Dec 30, 2015
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN176821 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2212

Mailing address

1306 Westchester RDG NE
Atlanta, GA 30329-2482
Phone (770) 265-5709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160229001890 GA Practitioner - Nurse Practitioner 2264737204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN176821GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Mar 1, 2016 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Mar 1, 2016 Accepting new patients
The Emory Clinic Inc CurrentSince Aug 7, 2016 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: rfuller68020@direct.emory.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1225493646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 WESTCHESTER RDG NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292482",
            "telephone_number": "770-265-5709",
            "fax_number": "404-688-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-686-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "RONALD",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-30",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN176821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.