Sara Michele Fuller, OTR
Individual provider Active NPI Occupational Therapist · Avilla, IN
NPI 1699035907 · NPPES record last updated Apr 12, 2024
Key facts
- NPI
- 1699035907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 31002824A (IN)
- Practice address
- 515 N Main St
Avilla, IN 46710-9601 - Phone
- (260) 897-2841
- NPI assigned
- May 21, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
303 N Hurstbourne Pkwy
Suite 200
Louisville, KY 40222-5158
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31002824A | IN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31002824A | IN | Yes |
Addresses
Primary practice location
515 N Main St
Avilla, IN 46710-9601
Mailing address
6230 Hathaway Rd
Fort Wayne, IN 46818-9545
Phone (260) 615-4437
Other providers in Avilla, IN
- Barbara Jean Cary
- James D. Chandler
- Rheta Denise Conner
- Phillip W. Corbin
- Fischer Pharmacare, LLC
- Alison Hullinger
- Dennis W. Lamp
- Kirsten Lane
- Lisa A. Lane
- Mycal L Mansfield
All providers in Avilla, IN · Occupational Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.