Shaune I Fuller-Gonzalez, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN106395 Issued in GA

Practice address

822 S Hill St
Griffin, GA 30224-4842

Phone

(770) 228-1181

NPI assigned

Sep 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1386127744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244842",
            "telephone_number": "770-228-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244842",
            "telephone_number": "770-228-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER-GONZALEZ",
        "first_name": "SHAUNE",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "106395",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN106395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quesha Kathleen Foster, CNP
• Kayla Nicole Fraire, DPT
• Mari Fraser
• Adrianne T Fritsche, M.ED., CCC-SLP
• Shannon Fuelling, M.A.
• Linda Mae Fulop, LAPC
• Susan O Furro, FNP-C; PMHNP-BC
• Elizabeth A Gailes, OTR/L
• Krishna Kanth Gali, MD
• Ruchi Parimal Gandhi, O.D.

• Family Nurse Practitioner in Griffin, GA
• Providers in Griffin, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.