Colin M Fuller, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

3987 Issued in NV

Practice address

2385 E Prater Way
Suite 302
Sparks, NV 89434-9629

Phone

(775) 356-4514

Fax

(775) 356-4991

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Sierra Nevada Cardiology Associates Catheterization Laboratory

  dba SNCA Cath Lab

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1184619025
  NPD
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1578555165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "775-356-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 E PRATER WAY",
            "address_2": "SUITE 302",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349629",
            "telephone_number": "775-356-4514",
            "fax_number": "775-356-4991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Spring Ridge Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Susanville",
            "state": "CA",
            "postal_code": "961306100",
            "country_code": "US",
            "telephone_number": "775-356-4514",
            "fax_number": "775-356-4991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "COLIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "3987",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G26986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11040349",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578555165",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G26986",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "3987",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Friedlander
• McKenna Frith
• Harry Calvin Fry, DDS
• Pamela C Frye, RN
• Full Circle Counseling, PLLC
• Katharina S Fung, DMD
• Kenneth Fung, RPH
• James Scott Furrow
• Alexis Cherie Gabrielson, APRN
• Gad 3 LLC

• Cardiovascular Disease Physician in Sparks, NV
• Providers in Sparks, NV by specialty
• Cardiovascular Disease Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.