Active NPI
Nancy S. Fuller, M.D.
- Hospitalist Physician
- Madison, WI
National Provider Identifier
1386760718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 54479-20
- Practice address
- 700 S Park St
Madison, WI 53715-1830 - Phone
- (608) 251-6100
- NPI assigned
- Mar 21, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 54479-20 | WI | |
| Hospitalist Physician | 208M00000X | 54479-20 | WI | Primary |
Addresses
Primary practice location
700 S Park St
Madison, WI 53715-1830
Mailing address
700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61039 | Other | WI | DEAN HEALTH INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54479-20 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Cincinnati Behavioral Health Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Walnut Hills, OH
- NPI 1588626097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1386760718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151830",
"telephone_number": "608-251-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "NANCY",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "54479-20",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "54479-20",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "61039",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.