Kelly Raye Fussell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP135802 Issued in TX

Practice address

1665 Antilley Rd Ste 120
Abilene, TX 79606

Phone

(325) 437-8680

Fax

(325) 793-5378

NPI assigned

Nov 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Raye Cunningham Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Primary Care Clinic AbileneGroup PAC ID 1557808037, 3 clinicians

West Texas Urgent Care LLCGroup PAC ID 1658632872, 14 clinicians

Practice addresses (Care Compare)

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.

• My Primary Care Clinic Abilene

  • Primary Care Clinic/Center
  • Abilene, TX
  • NPI 1376309294

  TX

  Medicare reassignment Care Compare group NPD
• West Texas Urgent Care LLC

  • Urgent Care Clinic/Center
  • Abilene, TX
  • NPI 1194146399

  TX

  Medicare reassignment Care Compare group NPD
• Abilene Emergency Physicians Staffing PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Abilene, TX
  • NPI 1407592405
  NPD
• West Texas Urgent Care LLC

  • Urgent Care Clinic/Center
  • Boerne, TX
  • NPI 1013764695
  NPD
• Privia Medical Group West Texas, PLLC

  • Pathology Specialist/Technologist
  • Abilene, TX
  • NPI 1760482665
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1467966697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5409",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796085409",
            "telephone_number": "325-437-8655",
            "fax_number": "325-437-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 ANTILLEY RD STE 120",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "79606",
            "telephone_number": "325-437-8680",
            "fax_number": "325-793-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "KELLY",
        "middle_name": "RAYE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CUNNINGHAM",
            "middle_name": "RAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles W Fuller, M.D.
• Douglas B Fullerton, MD
• Tiffany Anne Fullerton
• Dale A Funk, M.D.
• Glen G Funkey, PT, DPT
• G.R.I.T. Home Care Services LLC
• G&J Doctors Group
• Aizelle Ann Mayrina Gaddi
• Rebekah Gailey, LPC
• Lacy Gallaway Mankin, DDS

• All providers in Abilene, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.
• 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.