Individual provider Active NPI

Cassey Jo Fuller

  • Student in an Organized Health Care Education/Training Program
  • Mason City, IA
National Provider Identifier
1396434718
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1010 4TH St SW Ste 340
Mason City, IA 50401-2856
Phone
(641) 428-7766
Fax
(641) 428-7788
NPI assigned
May 2, 2023
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Family Medicine Physician 207Q00000X DO.4577 AL

Addresses

Primary practice location

1010 4TH St SW Ste 340
Mason City, IA 50401-2856

Mailing address

600 1St St NW Ste 101
Mason City, IA 50401-2932

Other practice location 1

975 9th Ave SW Ste 310
Bessemer, AL 35022-7839
Phone (205) 277-2358

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cfuller3944917@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230713002850 IA Order and Referring Only - Family PracticePractitioner - Family Practice 3870953441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DO.4577ALMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1396434718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 1ST ST NW STE 101",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 4TH ST SW STE 340",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012856",
            "telephone_number": "641-428-7766",
            "fax_number": "641-428-7788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 9th Ave SW Ste 310",
            "address_purpose": "LOCATION",
            "city": "Bessemer",
            "state": "AL",
            "postal_code": "350227839",
            "country_code": "US",
            "telephone_number": "205-277-2358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CASSEY JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.4577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cfuller3944917@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "MercyOne North Iowa Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1010 4th St SW Ste 340",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504012856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.