NPIMap

Individual provider Active NPI

Jacob Aaron Fuller, DO

  • Family Medicine Physician
  • Duncan, OK
National Provider Identifier
1669094371
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7292 Issued in OK
Practice address
2515 N Whisenant Dr Ste 301
Duncan, OK 73533-2684
Phone
(580) 251-6806
NPI assigned
May 15, 2020
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7292 OK Primary

Addresses

Primary practice location

2515 N Whisenant Dr Ste 301
Duncan, OK 73533-2684

Mailing address

2621 N Whisenant Dr
Duncan, OK 73533-0911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20230719003998 OK Practitioner - Family Practice 9638565039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duncan Regional Hospital, IncGroup PAC ID 5193613057, 69 clinicians

Practice addresses (Care Compare)

1415 N Whisenant Dr
Duncan, OK 73533-1650
Phone (580) 252-5300

2621 N Whisenant Dr
Duncan, OK 73533-0911
Phone (580) 252-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7292OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duncan Regional Hospital, Inc Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
Duncan Regional Hospital, Inc. Current Accepting new patients
Duncan Regional Hospital, Inc Family Medicine CurrentSince Mar 1, 2024 Accepting new patients

Locations

1415 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-6657

2230 Duncan Regional Loop
Duncan, OK 73533
Phone (580) 252-0100

2434 Harville Rd
Ste 601
Duncan, OK 73533
Phone (580) 252-1373

2515 N Whisenant Dr
Ste 301
Duncan, OK 73533
Phone (580) 251-6806

2945 W Elk Ave
Duncan, OK 73533
Phone (580) 252-3400

Interoperability endpoints

  • Direct secure messaging: jacob.fuller@direct.drhhealth.org

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1669094371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735330911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 N WHISENANT DR STE 301",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735332684",
            "telephone_number": "580-251-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JACOB",
        "middle_name": "AARON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.