Willie Michael Fussell, D.O.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

57620 Issued in GA

Practice address

3200 Gillionville Rd Ste 100
Albany, GA 31721-2815

Phone

(229) 405-2470

Fax

(229) 405-2473

NPI assigned

Oct 10, 2006

Last updated

Oct 26, 2022By 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 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

Ohio University, College of Osteopathic Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: willie.fussell@3901.securemail.prognocis.com
• Direct secure messaging: willie.fussell@4130.securemail.prognocis.com

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.

• Interventional Pain Institute LLC

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1508444837
  Medicare reassignment NPD Authorized official
• Interventional Pain Institute LLC

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1568003481
  Authorized official Same address or phone
• Regional Health Group Inc

  dba Musculoskeletal Associates

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1952576571
  Authorized official Same address or phone
• Interventional Pain Institute

  • Interventional Pain Medicine Physician
  • Morgantown, WV
  • NPI 1942680194
  NPD (past) Authorized official
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256

  Interventional Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1740377787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 OLD DAWSON ROAD",
            "address_2": "SUITE 2, BOX 245",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317071599",
            "telephone_number": "229-405-2470",
            "fax_number": "229-405-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GILLIONVILLE RD STE 100",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317212815",
            "telephone_number": "229-405-2470",
            "fax_number": "229-405-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "WILLIE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "57620",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "57620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "iPainInstitute@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Gillionville Rd Ste 100",
            "city": "Albany",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317212815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sue Lanier Freeman, PHYSICAL THERAPIST
• Shelia Michelle French-Hines
• William P Fricks, MD
• Joan C Fryer, LPC
• Susan E Fulmer, CNP
• Emily E Futch, DPT
• G Phillips Ventures Inc (Phillips Pharmacy)
• Ga Specialty Dental Services (Southwest Oral and Maxillofacial Surgery)
• Gabriel's Health Services Inc.
• Sailaja Gadde, MD

• Interventional Pain Medicine Physician in Albany, GA
• Providers in Albany, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.