NPIMap

Individual provider Active NPI

Tamara N. Fuller-Eddins, M.D.

  • Obstetrics & Gynecology Physician
  • Eagan, MN
National Provider Identifier
1265412480
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
58931 Issued in MN
Practice address
2805 Dodd Rd Ste 100
Eagan, MN 55121-2160
Phone
(651) 241-7733
Fax
(651) 241-0258
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 200101202 NC
Obstetrics & Gynecology Physician 207V00000X 46990 CO
Obstetrics & Gynecology Physician 207V00000X 9163 SD
Obstetrics & Gynecology Physician 207V00000X 58931 MN Primary

Addresses

Primary practice location

2805 Dodd Rd Ste 100
Eagan, MN 55121-2160

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfullereddins632418@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613002832 MN Practitioner - Obstetrics/Gynecology 8820215650 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Boston University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic 800 clinicians
Allina Health System 3,844 clinicians

Practice addresses (Care Compare)

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

2805 Dodd Rd
Suite 100
Eagan, MN 55121-2160
Phone (651) 241-7733

Hospital & facility affiliations

  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46990COMDObstetrics & Gynecology Physician
200101202NCMDObstetrics & Gynecology Physician
9163SDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Apr 17, 2023 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Apr 17, 2023 Accepting new patients
Allina Health System CurrentSince Jul 10, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Centracare Clinic Current Accepting new patients
Allina Health System CurrentSince Jul 10, 2023 Accepting new patients
Centracare Clinic CurrentSince Nov 1, 2025 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
Centracare Clinic CurrentSince Nov 1, 2025 Accepting new patients
Allina Health System Past Accepting new patients
Centracare Clinic Past Accepting new patients
Allina Health System Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1001 E Superior St
Ste 301
Duluth, MN 55802
Phone (218) 249-4700

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

2805 Dodd Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 241-7733

347 Smith Ave N
Ste 203
Saint Paul, MN 55102
Phone (651) 241-7733

Interoperability endpoints

  • Direct secure messaging: tfullereddins632418@excellian.direct.allina.com

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1265412480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 DODD RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212160",
            "telephone_number": "651-241-7733",
            "fax_number": "651-241-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER-EDDINS",
        "first_name": "TAMARA",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200101202",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "46990",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SD",
            "license": "9163",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "58931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfullereddins632418@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2805 Dodd Rd Ste 100",
            "city": "Eagan",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551212160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.