Active NPI
Dewaskie Fuller
- Case Manager/Care Coordinator
- Natchitoches, LA
National Provider Identifier
1770948135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 122 Kyle St
Natchitoches, LA 71457-3686 - Phone
- (318) 518-5542
- NPI assigned
- Dec 29, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
122 Kyle St
Natchitoches, LA 71457-3686
Mailing address
122 Kyle St
Natchitoches, LA 71457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1770948135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 KYLE ST",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "71457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 KYLE ST",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714573686",
"telephone_number": "318-518-5542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "DEWASKIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-29",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Natchitoches, LA
- Donna Frazier
- Fresenius Medical Care Natchitoches, LLC
- Fresenius Medical Care Natchitoches, LLC
- Loura Steadman Frye, MA LPC LMFT NCC
- Sadie Ann Fudge
- Future Expectation Community Care Services
- Future Expectations Community Care Services
- Future Expectations Community Care Services
- Future Expectations Community Care Services
- Samy Nabil Sadeek Gad
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.