Fuller Health & Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

FULLER HEALTH & NUTRITION, LLC

Practice address

2873 Fall Creek Dr
Grand Junction, CO 81503-3057

Phone

(970) 640-8023

NPI assigned

Feb 7, 2023

Organization subpart

No

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

Authorized official

Name

Nicole K Fuller, RDNPI 1881362663

Title

Owner/Registered Dietitian

Phone

(970) 640-8023

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Kathleen Fuller, RD

  • Registered Dietitian
  • Grand Junction, CO
  • NPI 1881362663

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1487350799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 FALL CREEK DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815033057",
            "telephone_number": "970-640-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2873 FALL CREEK DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815033057",
            "telephone_number": "970-640-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER HEALTH & NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "970-640-8023",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "I AM THE ONLY PROVIDER",
            "identifier": "1881362663",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frontier Medicine LLC
• Fruita Family Medicine PLLC
• Constance Noelle Fry, MA, NCC
• Issac Tyler Frye
• Karen E Frye, D.O
• Jeena Fuller, PA-C
• Mackenzie Fuller
• Nicole Kathleen Fuller, RD
• Joshua Fullmer, MS, ATC
• Rebecca Fulmer, M.D.

• Registered Dietitian in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.