Active NPI
Cheryl A Fuller, APN
- Family Nurse Practitioner
- Dongola, IL
National Provider Identifier
1376851410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209008363
- Practice address
- 318 US Highway 51 N
Dongola, IL 62926-1103 - Phone
- (618) 827-3545
- Fax
- (618) 827-4891
- NPI assigned
- Sep 23, 2010
- Last updated
- Apr 25, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209008363 | IL | Primary |
Addresses
Primary practice location
318 US Highway 51 N
Dongola, IL 62926-1103
Mailing address
PO Box 277
Dongola, IL 62926-0277
Phone (618) 827-3545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
318 US Hwy 51 N
Dongola, IL 62926-1103
Phone (618) 827-3545
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Health, Inc. | Current | Accepting new patients | |
| Rural Health, Inc. | Current | Accepting new patients | |
| Rural Health, Inc. | Past | Accepting new patients |
Locations
513 N Main St
Anna, IL 62906
Phone (618) 833-4471
Interoperability endpoints
- cheryl.fuller.1@7601.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Anna, IL
- NPI 1982666384
-
dba Dongola Medical Clinic
- Federally Qualified Health Center (FQHC)
- Dongola, IL
- NPI 1366506628
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Deaconess Illinois Union County
- Critical Access Hospital
- Anna, IL
- NPI 1710604483
-
dba Deaconess Illinois Medical Center
- General Acute Care Hospital
- Marion, IL
- NPI 1750007266
-
- Home Health Agency
- Marion, IL
- NPI 1235556838
-
dba Memorial Hospital of Carbondale
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
-
dba Herrin Hospital
- General Acute Care Hospital
- Herrin, IL
- NPI 1528158573
-
- General Acute Care Hospital
- Cape Girardeau, MO
- NPI 1467412726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461542400000",
"number": "1376851410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 277",
"city": "DONGOLA",
"state": "IL",
"postal_code": "629260277",
"telephone_number": "618-827-3545",
"fax_number": "618-827-4891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 US HIGHWAY 51 N",
"city": "DONGOLA",
"state": "IL",
"postal_code": "629261103",
"telephone_number": "618-827-3545",
"fax_number": "618-827-4891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "CHERYL",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-23",
"last_updated": "2016-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209008363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dongola, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.