Individual provider Active NPI

Mary N. Fuller, APRN

  • Family Nurse Practitioner
  • Harrodsburg, KY
National Provider Identifier
1245775428
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010827 Issued in KY
Practice address
1064 N College St
Harrodsburg, KY 40330-2208
Phone
(859) 734-3057
Fax
(502) 839-3806
NPI assigned
Dec 27, 2016
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3010827 KY Primary

Addresses

Primary practice location

1064 N College St
Harrodsburg, KY 40330-2208

Mailing address

PO Box 195
Salvisa, KY 40372-0195
Phone (502) 839-3805

Other practice location 1

1075 E Lexington Ave
Danville, KY 40422-1766
Phone (859) 712-2041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20170127002513 KY Practitioner - Nurse Practitioner 4587946405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kentucky College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spivey Medical, PLLCGroup PAC ID 1355650300, 9 clinicians

Practice addresses (Care Compare)

1075 E Lexington Ave
Danville, KY 40422-1766
Phone (859) 712-2041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3010827KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spivey Medical, PLLC CurrentSince Nov 22, 2025 Accepting new patients
Ephraim McDowell Health Resource, Inc PastSince Jan 24, 2018 Accepting new patients

Locations

1075 E Lexington Ave
Danville, KY 40422
Phone (859) 712-2041

1064 N College St
Harrodsburg, KY 40330
Phone (859) 734-3004

92 Plaza Dr
Lawrenceburg, KY 40342
Phone (502) 839-3805

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22146/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mfuller43832@direct.nortonhealthcare.org

Organizations & group practices 2

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 3

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1245775428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "SALVISA",
            "state": "KY",
            "postal_code": "403720195",
            "telephone_number": "502-839-3805",
            "fax_number": "502-839-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 N COLLEGE ST",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403302208",
            "telephone_number": "859-734-3057",
            "fax_number": "502-839-3806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 E Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "KY",
            "postal_code": "404221766",
            "country_code": "US",
            "telephone_number": "859-712-2041",
            "fax_number": "502-839-3806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MARY",
        "middle_name": "N.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrodsburg, KY

Sources for this page

Verify at the official NPI Registry.