Active NPI
Sarah Fuller
- Athletic Trainer
- Milledgeville, GA
National Provider Identifier
1679970545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT002580
- Practice address
- 231 West Hancock Street
Campus Box 65
Milledgeville, GA 31061 - Phone
- (478) 445-1787
- NPI assigned
- Nov 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT002580 | GA | Primary |
Addresses
Primary practice location
231 West Hancock Street
Campus Box 65
Milledgeville, GA 31061
Mailing address
640 W Thomas St
Apt 105
Milledgeville, GA 31061-2356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT002580 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1679970545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 W THOMAS ST",
"address_2": "APT 105",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310612356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 WEST HANCOCK STREET",
"address_2": "CAMPUS BOX 65",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "31061",
"telephone_number": "478-445-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT002580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.