Teresa Lorraine Fuller, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R-12561 Issued in IA

Practice address

1801 Hickman Rd
Des Moines, IA 50314-1548

Phone

(515) 282-2200

NPI assigned

May 10, 2022

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 IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas County HospitalGroup PAC ID 9931094257, shared by 6 NPIs, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dallas County Hospital Hospital, Perry, IA, CCN 161322
• Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fuller.teresa@cynchealthdsm.org
• Direct secure messaging: teresafuller@dcfm.allscriptsdirect.net
• FHIR API: https://fhir-usa.unify.chbase.com/org/dallas-858d3687

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.

• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Dallas County Hospital

  • Critical Access Hospital
  • Perry, IA
  • NPI 1669477089
  Medicare reassignment NPD
• Dallas County Hospital

  • Emergency Medicine Physician
  • Perry, IA
  • NPI 1861416307

  Family Medicine

  Medicare reassignment NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• Dallas County Hospital

  • Rural Health Clinic/Center
  • Panora, IA
  • NPI 1023676400

  Family Medicine

  NPD
• Dallas County Hospital

  • Rural Health Clinic/Center
  • Dallas Center, IA
  • NPI 1194412478

  Family Medicine

  NPD

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

• Catholic Health Initiatives - Iowa Corp

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1538395975
  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • Clinical Medical Laboratory
  • Des Moines, IA
  • NPI 1104982743

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives-Iowa Corp

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1508964883
  Care Compare affiliation
• Catholic Health Initiatives, Ia-Corp

  • Mammography Clinic/Center
  • Des Moines, IA
  • NPI 1477984367

  Hospital

  Care Compare affiliation
• Dallas County Hospital

  • Critical Access Hospital
  • Perry, IA
  • NPI 1669477089
  Care Compare affiliation

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1679219737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 E 38TH CT",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503175732",
            "telephone_number": "515-452-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141548",
            "telephone_number": "515-282-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TERESA",
        "middle_name": "LORRAINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-12561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Fredrick Fuller, DDS
• C Fredrick Fuller
• Michael Fuller, PHARMD
• Stephanie Fuller, LMSW
• Steven Craig Fuller, DDS
• Tyler Fulton, OD
• Kevin James Furness, D.O.
• Kate Margaret Furst, PHARMD
• Nicholas John Fustino, M.D.
• Jerry Futer, LISW

• Family Medicine Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.