Active NPI
Amy Fuller, M.D.
- Emergency Medicine Physician
- Washington, NC
National Provider Identifier
1366898710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2020-00792
- Practice address
- 628 E 12TH St
Washington, NC 27889-3409 - Phone
- (252) 975-4319
- Fax
- (252) 948-4826
- NPI assigned
- May 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2020-00792 | NC | Primary |
Addresses
Primary practice location
628 E 12TH St
Washington, NC 27889-3409
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other practice location 1
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662
Hospital & facility affiliations
- Alaska Native Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.93 of 100
- Quality
- 70.1
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.01
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020-00792 | NC | MD | Emergency Medicine Physician |
Practice roles
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
WA
-
- Clinic/Center
- Koliganek, AK
- NPI 1013079607
-
- Clinic/Center
- Ekwok, AK
- NPI 1104988799
-
- Clinic/Center
- Pilot Point, AK
- NPI 1174683825
-
- Clinic/Center
- Platinum, AK
- NPI 1285796870
-
- Clinic/Center
- Levelock, AK
- NPI 1366502767
-
- Clinic/Center
- South Naknek, AK
- NPI 1417018193
-
- Clinic/Center
- Twin Hills, AK
- NPI 1487716825
-
- Clinic/Center
- Perryville, AK
- NPI 1528128782
-
- Clinic/Center
- Chignik Lagoon, AK
- NPI 1578623641
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1023290855
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1093924458
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1235348343
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1245439082
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1376752469
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1407065899
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1437189339
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1437368891
-
- Ambulatory Surgical Clinic/Center
- Anchorage, AK
- NPI 1558570648
Hospital
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Anchorage, AK
- NPI 1679931059
Hospital
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1750590840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587600000000",
"number": "1366898710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 E 12TH ST",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893409",
"telephone_number": "252-975-4319",
"fax_number": "252-948-4826"
}
],
"practiceLocations": [
{
"address_1": "2100 Stantonsburg Rd",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278342818",
"country_code": "US",
"telephone_number": "252-847-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FULLER",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-04",
"last_updated": "2020-04-23",
"certification_date": "2020-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2020-00792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.