Individual provider Active NPI

Norman Eugene Fuller, D.C.

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1457440984
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
251 Issued in AK
Practice address
833 W Commercial Dr
Wasilla, AK 99654-6937
Phone
(907) 376-2475
Fax
(907) 373-5154
NPI assigned
Oct 12, 2006
Last updated
Oct 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 251 AK Primary

Addresses

Primary practice location

833 W Commercial Dr
Wasilla, AK 99654-6937

Mailing address

833 W Commercial Dr
Wasilla, AK 99654-6937
Phone (907) 376-2475

Other identifiers 1

IdentifierTypeStateIssuer
CH0251MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000045 AK Practitioner - Chiropractic 0345234092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

833 Commercial Dr
Wasilla, AK 99654-6937

833 W Commercial Dr
Wasilla, AK 99654-6937
Phone (907) 376-2475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
251AKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Norman E Fuller PC Chiropractor CurrentSince Jan 1, 2001 Accepting new patients

Locations

833 W Commercial Dr
Wasilla, AK 99654
Phone (907) 376-2475

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1457440984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 W COMMERCIAL DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546937",
            "telephone_number": "907-376-2475",
            "fax_number": "907-373-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 W COMMERCIAL DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546937",
            "telephone_number": "907-376-2475",
            "fax_number": "907-373-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NORMAN",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0251",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.