Mary Fuller-Fougerousse

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP3545 Issued in AZ

Practice address

502 W 29TH St
Tucson, AZ 85713-3353

Phone

(520) 884-9920

NPI assigned

Jan 5, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryfuller-fougerousse@lfcenter.netsmartdirect.net

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.

• La Frontera Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1093810889
  NPD
• Inner Journey Psychological Services, LLC

  • Clinical Psychologist
  • Tucson, AZ
  • NPI 1073560793
  NPD (past)
• La Frontera Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1932404225
  NPD (past)
• Lafrontera Center Inc.

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1073614905
  NPD (past)

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1336479906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W 29TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857133353",
            "telephone_number": "520-884-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W 29TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857133353",
            "telephone_number": "520-884-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER-FOUGEROUSSE",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP3545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Analydia Gonzales Fulcher, AU.D.
• Full Circle Counseling and Consulting, LLC
• Full Circle Physical Therapy PLLC
• Full Circle Transportation
• Full Spectrum Wellness Inc
• Amelia E Fuller, LMT
• Heather Lynn Fuller, RPH
• Sidney J. Fuller, CCP
• Tamera Fuller, MC, LPC
• Rachel Cathleen Fullington, D.O

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.