Active NPI
Trevecca Michelle Fuller
- Case Manager/Care Coordinator
- Lexington, KY
National Provider Identifier
1326753443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3131 Custer Dr Ste 4a
Lexington, KY 40517-4006 - Phone
- (859) 298-5629
- NPI assigned
- Jan 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3131 Custer Dr Ste 4a
Lexington, KY 40517-4006
Mailing address
94 Kingsbury LN
Cynthiana, KY 41031-4408
Phone (859) 298-5629
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0310 | Other | HOME CARE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | FullersFamilyHomeCare | Health Information Exchange (HIE) | |
| Direct Messaging Address | michellefuller2023@outlook.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675814400000",
"number": "1326753443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 KINGSBURY LN",
"city": "CYNTHIANA",
"state": "KY",
"postal_code": "410314408",
"telephone_number": "859-298-5629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 CUSTER DR STE 4A",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405174006",
"telephone_number": "859-298-5629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "TREVECCA",
"middle_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-23",
"last_updated": "2023-02-08",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME CARE",
"identifier": "0310",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "FullersFamilyHomeCare",
"affiliation": "N",
"endpointDescription": "Home Care",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3131 Custer Dr Ste 4",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405174006",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "michellefuller2023@outlook.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3131 Custer Dr Ste 4",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405174006",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.