Stephanie M Fuller, PH.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

427 Issued in SD

Practice address

3515 Broadway Ave.
Yankton, SD 57078-7600

Phone

(605) 668-3100

Fax

(605) 668-3460

NPI assigned

Feb 13, 2013

Last updated

Feb 13, 2013By the provider in NPPES

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 SD

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis and Clark Behavioral Health Services IncGroup PAC ID 9436145273, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lewis & Clark Behavioral Health Services, Inc.

  • Community/Behavioral Health Agency
  • Yankton, SD
  • NPI 1215918339
  Medicare reassignment Care Compare group NPD
• Lewis & Clark Mental Health Center

  dba Lewis & Clark Behavioral Health Services

  • Mental Health Counselor
  • Yankton, SD
  • NPI 1972862969
  NPD (past)
• State of South Dakota

  dba SD Human Services Center

  • Psychiatric Hospital
  • Yankton, SD
  • NPI 1124027586
  NPD (past)
• State of South Dakota

  dba USD Speech & Hearing Clinic

  • Audiologist
  • Vermillion, SD
  • NPI 1346366044
  NPD (past)

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1639418494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7600",
            "address_2": "3515 BROADWAY AVE.",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570787600",
            "telephone_number": "605-668-3100",
            "fax_number": "605-668-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE.",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570787600",
            "telephone_number": "605-668-3100",
            "fax_number": "605-668-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SD",
            "license": "427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Frank, MD
• Savannah Frank
• James A Frerk, P.A.
• Kassandra Frey, MSW, CSW-PIP
• Jean Friedenbach, CCC-SLP
• Melissa A Fullner-Marshall, PA
• Rachael Megan Gaertner
• Kari Lin Gall, PTA
• Ryan Joseph Garry, M.D.
• Erica J Garvey, PT, DPT

• Specialist in Yankton, SD
• Providers in Yankton, SD by specialty
• Specialist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.