Angelia Fuller, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9170137 Issued in FL

Practice address

1750 Tree Blvd Ste 5
St Augustine, FL 32084-5719

Phone

(904) 342-0672

NPI assigned

Feb 12, 2014

Last updated

Mar 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monogram Health Professional Services of Florida LLCGroup PAC ID 0244608149, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angelia.fuller.1@22854.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/GJGIBD

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.

• Monogram Health Professional Services of Florida LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1538883111

  Family

  Medicare reassignment Care Compare group NPD
• Mobile Visiting Practitioners, LLC

  • Primary Care Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1265915359
  Medicare reassignment NPD
• Panacea Alliance Corp.

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1326298803
  Medicare reassignment NPD
• West Volusia Family and Sports Medicine Inc

  • Family Medicine Physician
  • Deland, FL
  • NPI 1548584600
  Medicare reassignment NPD
• Behavioral Health Services of Florida LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1619649217
  NPD

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1366866204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-342-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-342-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ANGELIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9170137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102979000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akinkawon Tahir Frierson, LABORATORY DIRECTOR
• Joann Fritsch
• Ronald D Fudala, DC,DACAN
• Paul Fugelsang
• Full Bloom Chiropractic Corp
• Antonia Fuller, A.R.N.P.
• Bryant Fuller, CRNA
• Chrystal Fuller
• Ashley Fulton
• Angela Marie Fusco, LMHC

• Family Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.