Individual provider Active NPI

Griffin Lowe Fuller, M.D.

  • Internal Medicine Physician
  • Georgetown, TX
National Provider Identifier
1730573254
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S3661 Issued in TX
Practice address
4500 Williams Dr Ste 285
Georgetown, TX 78633-1339
Phone
(512) 869-4800
Fax
(512) 868-8801
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S3661 TX
Family Medicine Physician 207Q00000X 11018498A IN
Internal Medicine Physician 207R00000X S3661 TX Primary

Addresses

Primary practice location

4500 Williams Dr Ste 285
Georgetown, TX 78633-1339

Mailing address

825 E Rundberg LN Ste B1
Austin, TX 78753-4860
Phone (512) 978-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200228001127 TX Practitioner - Internal Medicine 6800109448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

4500 Williams Drive
285 Wellmed at Georgetown
Georgetown, TX 78633-1339
Phone (512) 869-4800

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, San Antonio, TX, CCN 679044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S3661TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine CurrentSince Oct 6, 2025 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Oct 6, 2025 Accepting new patients
Ascension Seton Family Medicine Past Accepting new patients

Locations

3708 Jefferson St
Austin, TX 78731
Phone (512) 459-6503

4500 Williams Dr
Ste 285
Georgetown, TX 78633
Phone (512) 869-4800

1750 Round Rock Ave
Ste 100
Round Rock, TX 78681
Phone (512) 388-9495

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: griffin.fuller@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1730573254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN STE B1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534860",
            "telephone_number": "512-978-9600",
            "fax_number": "512-901-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 WILLIAMS DR STE 285",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331339",
            "telephone_number": "512-869-4800",
            "fax_number": "512-868-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "GRIFFIN",
        "middle_name": "LOWE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3661",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11018498A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S3661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.