Selena Fuller, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN172405 Issued in GA

Practice address

2779 Cobb Pkwy NW
Kennesaw, GA 30152-3437

Phone

(678) 732-1500

NPI assigned

May 29, 2013

Sex

Female

Sole proprietor

No

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

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Piedmont Professional Services, LLC

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1104088905
  Medicare reassignment Care Compare group
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1598102733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2779 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523437",
            "telephone_number": "678-732-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 South Clayton Street",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30045",
            "country_code": "US",
            "telephone_number": "866-825-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SELENA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN172405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN172405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elspeth A. French, OT
• Friends Today, LLC.
• Full Blossom Behavioral Health Consultants, LLC
• Fuller Rehabilitation and Consulting Services, Inc.
• Ariana Fuller, RBT
• Kenisha Teree Funches, LPN
• Alannah Fuselier
• Ga Doctors of Optometry LLC
• Jason Gabriel, LAPC
• Niekquan Kobe Gadson

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.