Laura Marie Fuller, MS,RDN,LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2001026126 Issued in MO

Practice address

197 N McCleary Rd
Excelsior Springs, MO 64024-8490

Phone

(816) 922-2411

Fax

(816) 922-4644

NPI assigned

Jul 27, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1770968240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 N MCCLEARY RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248490",
            "telephone_number": "816-922-2411",
            "fax_number": "816-922-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 N MCCLEARY RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248490",
            "telephone_number": "816-922-2411",
            "fax_number": "816-922-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "credential": "MS,RDN,LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2001026126",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "1859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Excelsior Springs, MO
• Providers in Excelsior Springs, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.