Jeffrey Fuller

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT032534 Issued in TX

Practice address

3824 Cedar Springs Rd # 433
Dallas, TX 75219-4136

Phone

(214) 306-5401

Fax

(214) 206-9073

NPI assigned

Oct 16, 2013

Last updated

Oct 16, 2013By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1730517368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 CEDAR SPRINGS RD # 433",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194136",
            "telephone_number": "214-306-5401",
            "fax_number": "214-206-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 CEDAR SPRINGS RD # 433",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194136",
            "telephone_number": "214-306-5401",
            "fax_number": "214-206-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT032534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah A Fuller, M.D.
• Dwain Fuller, M.D. .
• Elise Fuller, COTA
• Elise J Fuller, MA, LPC
• Grant Fuller, OTA
• Julie Marie Fuller, MD
• Kelcie Denea Fuller
• Lakeshia Rena Fuller, RN
• Lauren Caroline Fuller
• Michelle L Fuller, NPC

• Massage Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.