Nichole Leshawn Fuller

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704280454 Issued in MI

Practice address

1428 Leupp CT
Rochester Hills, MI 48307-3021

Phone

(313) 492-8911

NPI assigned

Apr 5, 2018

Last updated

Apr 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Halo Medical Group PLLCGroup PAC ID 1850587890, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
• Harper University Hospital Hospital, Detroit, MI, CCN 230104
• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfuller1127369@direct.hfhs.org

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.

• Halo Medical Group PLLC

  • Cardiovascular Disease Physician
  • Detroit, MI
  • NPI 1811214489
  Medicare reassignment Care Compare group NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Portage, MI
  • NPI 1669091864
  Medicare reassignment NPD
• Harmonycares Complete Health Services, PLLC

  dba HarmonyCares Health Services

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1093543902

  Nurse Practitioner

  NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• VHS Detroit Receiving Hospital Inc

  dba Detroit Receiving Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998
  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  dba Harper University Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation
• VHS Sinai-Grace Hospital Inc

  dba Sinai-Grace Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044
  Care Compare affiliation

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1720584899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 LEUPP CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 LEUPP CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073021",
            "telephone_number": "313-492-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NICHOLE",
        "middle_name": "LESHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704280454",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704280454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drita Fron, LMSW
• Gavin Andrus Fruge, DDS
• Jun Fu, O,D,
• Fugle and Associates PC
• Megan Fulkerson
• Shelia Arlene Fuller, O.D.
• Funktional Sleep PLLC
• Emma Katherine Gaboury
• Elizabeth Gaddis
• Alexandra Gadzinski, LPC

• Acute Care Nurse Practitioner in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.