Nancy Louise Fuller, LICPSY

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11081 Issued in MA

Practice address

275 Nichols Rd
Fitchburg, MA 01420-1919

Phone

(978) 401-3970

NPI assigned

Jan 16, 2007

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

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Community Health Connections, IncGroup PAC ID 8729074992, 91 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nancy.fuller.p1@direct.chcfhc.nextgenshare.com

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.

• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fitchburg, MA
  • NPI 1477580827
  Medicare reassignment Care Compare group NPD
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gardner, MA
  • NPI 1225742174
  NPD
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gardner, MA
  • NPI 1285630533
  NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1497806491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 WAMPUM ST",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027621605",
            "telephone_number": "508-695-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201919",
            "telephone_number": "978-401-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NANCY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LICPSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Fraser, PA
• Karylan Frazier
• Jason Freitas
• Fresh Start Home Care LLC
• Paula S Fuentes, BS
• Danilo Tolentino Funa, M.D.
• Joel Furnanz
• Viktoriya Fuzaylova
• G&T Healthcare, LLC
• Cynthia P Gagne, MS, LMHC

• Clinical Psychologist in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.