Individual provider Active NPI

Wendy S Fuller, NP

  • Adult Health Nurse Practitioner
  • Social Circle, GA
National Provider Identifier
1700840568
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN082682 NP Issued in GA
Practice address
551 N Cherokee Rd
Social Circle, GA 30025-2887
Phone
(678) 342-6000
Fax
(678) 342-6006
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN082682 NP GA Primary

Addresses

Primary practice location

551 N Cherokee Rd
Social Circle, GA 30025-2887

Mailing address

551 N Cherokee Rd
Social Circle, GA 30025-2887
Phone (678) 342-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20060125000204 GA Practitioner - Nurse Practitioner 9739103037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

4181 Hospital Dr NE
Covington, GA 30014-2541

6175 Newton Dr NE
Covington, GA 30014-2690
Phone (770) 787-6900

9202 Hwy 278 NE
Covington, GA 30014-7011
Phone (678) 342-8660

Hospital & facility affiliations

  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN082682 NPGAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation CurrentSince May 15, 2017 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Aug 6, 2011 Accepting new patients
Piedmont Providers LLC Past Accepting new patients
Newton County Medical Associates, PC Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

6175 Newton Dr NE
Covington, GA 30014
Phone (770) 787-5600

5278 Adams St NE
Covington, GA 30014
Phone (770) 786-2201

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

551 N Cherokee Rd
Social Circle, GA 30025
Phone (678) 342-6000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700840568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 N CHEROKEE RD",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300252887",
            "telephone_number": "678-342-6000",
            "fax_number": "678-342-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 N CHEROKEE RD",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300252887",
            "telephone_number": "678-342-6000",
            "fax_number": "678-342-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "WENDY",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN082682 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Social Circle, GA

Sources for this page

Verify at the official NPI Registry.