Wayne B Fuller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S320TA285 Issued in AL

Practice address

210 2ND Ave SE
Cullman, AL 35055-3514

Phone

(256) 734-1121

Fax

(256) 734-1991

NPI assigned

Oct 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fuller Optical

  • Optometrist
  • Cullman, AL
  • NPI 1417803354
  NPD Authorized official
• Fuller Optical, LLC

  • Point of Service
  • Cullman, AL
  • NPI 1093071193
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689761041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 2ND AVE SE",
            "address_2": "P. O. BOX 1067",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553514",
            "telephone_number": "256-734-1121",
            "fax_number": "256-734-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 2ND AVE SE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553514",
            "telephone_number": "256-734-1121",
            "fax_number": "256-734-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "WAYNE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S320TA285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51521397",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayden Friesen
• Cassandra W Frieson, DNP, CRNP
• Fuller Optical
• Fuller Optical, LLC
• Steven B Fuller, D.O.
• Jamie Gandy
• Leah Varden Gann, CRNP
• Denise Elaine Gardner, CRNP
• Chris Garnett
• Jennifer Lashay Garrison

• Optometrist in Cullman, AL
• Providers in Cullman, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.