NPIMap

Individual provider Active NPI

Dana Fuller, FNP

  • Family Medicine Physician
  • Clinton, SC
National Provider Identifier
1578125837
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22692 Issued in SC
Practice address
300 Plaza Cir Ste E
Clinton, SC 29325-7557
Phone
(864) 938-9690
Fax
(864) 833-9039
NPI assigned
Jul 7, 2019
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22692 SC
Family Medicine Physician 207Q00000X 22692 SC Primary

Addresses

Primary practice location

300 Plaza Cir Ste E
Clinton, SC 29325-7557

Mailing address

300 Plaza Cir Ste E
Clinton, SC 29325-7557
Phone (864) 938-9690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429001011 SC Practitioner - Nurse Practitioner 4183140544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Family Medicine of Laurens County PAGroup PAC ID 3375602048, 3 clinicians

Practice addresses (Care Compare)

300 Plaza Cir
Suite E
Clinton, SC 29325-7557
Phone (864) 938-9690

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Medicine of Laurens County PA CurrentSince Dec 1, 2024 Accepting new patients

Locations

300 Plaza Cir
Clinton, SC 29325
Phone (864) 871-1843

300 Plaza Cir
Ste E
Clinton, SC 29325
Phone (864) 938-0425

600 Plaza Cir
Clinton, SC 29325
Phone (864) 833-0055

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1578125837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PLAZA CIR STE E",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257557",
            "telephone_number": "864-938-9690",
            "fax_number": "864-833-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PLAZA CIR STE E",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257557",
            "telephone_number": "864-938-9690",
            "fax_number": "864-833-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-07",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22692",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, SC

Sources for this page

Verify at the official NPI Registry.