Lisa Ellen Fuller, MS, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1000893 Issued in TN

Practice address

3802 Sevierville Pike # 2
Knoxville, TN 37920-4551

Phone

(540) 293-3273

NPI assigned

Oct 8, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1457958746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 SEVIERVILLE PIKE # 2",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204551",
            "telephone_number": "540-293-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 SEVIERVILLE PIKE # 2",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204551",
            "telephone_number": "540-293-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LISA",
        "middle_name": "ELLEN",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "TN",
            "license": "2282",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "1000893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuller Rehabilitation and Consulting Services Inc. (Fuller Rehabilitation)
• Anthony Blair Fuller, LPC, MHSP
• Jason Fuller, DPT
• Katherine L Fuller, AUD
• Lisa Ann Fuller, FNP-BC
• Teia Squires Fuller, PT, DPT
• D. Shane Fulmer, O.T.
• Paula Katherine Fulton, NNP
• Sarah Fulton
• John Fultz

• Registered Dietitian in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Registered Dietitian in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.