Kathleen Marie Fuller, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

RN2297885 Issued in MA

Practice address

300 Congress St
Suite 102
Quincy, MA 02169-0907

Phone

(617) 479-6636

Fax

(617) 376-0435

NPI assigned

Apr 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Crown Obstetrics & Gynecology P.C.

  • Obstetrics & Gynecology Physician
  • Quincy, MA
  • NPI 1811920531
  NPD (past)
• Crown Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Quincy, MA
  • NPI 1487924239
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1689638371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CONGRESS ST",
            "address_2": "SUITE 102",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690907",
            "telephone_number": "617-471-1161",
            "fax_number": "617-376-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CONGRESS ST",
            "address_2": "SUITE 102",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690907",
            "telephone_number": "617-479-6636",
            "fax_number": "617-376-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MA",
            "license": "RN2297885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "RN2297885",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Frontino, PTA
• Sarah Marie Fryc, M.D.
• Shayne Fryia, DC
• Vanessa Fuentes
• Carina Lynn Fuller, MA
• Claire Y Fung, M.D.
• Hak Yung Fung, ACUPUNCTURIST
• Robert Kirby Fuqua IV
• David Furlong, B.A.
• Lauren Katie Fusek, FNP

• Obstetrics & Gynecology Nurse Practitioner in Quincy, MA
• Providers in Quincy, MA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.