Deronte Fullerton

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2785 Som Center Rd
Willoughby Hills, OH 44094-6501

Phone

(216) 278-0288

NPI assigned

Nov 2, 2023

Sex

Male

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

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.

• Bridges Csa Inc

  • Community/Behavioral Health Agency
  • Cleveland, OH
  • NPI 1245808757
  NPD

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1497528236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 E 219TH ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441231102",
            "telephone_number": "216-703-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 SOM CENTER RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440946501",
            "telephone_number": "216-278-0288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17325 Euclid Ave Ste 4012",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441121262",
            "country_code": "US",
            "telephone_number": "216-438-3349",
            "fax_number": "216-250-8148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "DERONTE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-02",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Frate, QMHS
• Michael James Freas, LISW
• Freedomshepherd, LLC
• Wilfred Fredrick Fromm, DDS
• Lauren Fueger
• Alexandra Fushi, DMD
• Chelsea Marie Garcia, NP
• George Andrew Gardner II
• Nancy W. Garlisi, D.D.S.
• Gary B. Kaplan, M.D.,Inc

• Case Manager/Care Coordinator in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.