Individual provider Active NPI

Della K Fuller

  • Obstetrics & Gynecology Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1669506713
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
1-056016 Issued in AL
Practice address
495 Taylor Rd
Montgomery, AL 36117-3513
Phone
(334) 279-9333
Fax
(334) 279-9057
NPI assigned
Mar 14, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 1-056016 AL Primary

Addresses

Primary practice location

495 Taylor Rd
Montgomery, AL 36117-3513

Mailing address

495 Taylor Rd
Montgomery, AL 36117-3513
Phone (334) 279-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20070518000556 AL Practitioner - Nurse Practitioner 5496852899 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Health Family Medicine PLLCGroup PAC ID 9931444353, 2 clinicians

Practice addresses (Care Compare)

7216 Copperfield Dr
Montgomery, AL 36117-7100
Phone (334) 244-1359

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Jul 31, 2017 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Jul 31, 2017 Accepting new patients
OB-GYN Associates of Montgomery, P.C. CurrentSince Nov 1, 2007 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

495 Taylor Rd
Montgomery, AL 36117
Phone (334) 279-9333

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1669506713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173513",
            "telephone_number": "334-279-9333",
            "fax_number": "334-279-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173513",
            "telephone_number": "334-279-9333",
            "fax_number": "334-279-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DELLA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AL",
            "license": "1-056016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.