John Thomas Fuller, IDHS

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

12239 Cressida Loop
Daphne, AL 36526-9001

Phone

(205) 901-4498

NPI assigned

Oct 20, 2021

Last updated

Oct 20, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1518620186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12239 CRESSIDA LOOP",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269001",
            "telephone_number": "205-901-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12239 CRESSIDA LOOP",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269001",
            "telephone_number": "205-901-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "IDHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa D Foster, OTR/L
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• Stacy A Free, OTR/L
• Clarissa Gable
• Anna Gafford
• Susan Galberry, MS, LPC
• Daniel Phillip Gardner, FNP
• Sara Waite Garrett, MA, LMFT

• Independent Duty Corpsman in Daphne, AL
• Providers in Daphne, AL by specialty
• Independent Duty Corpsman in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.