Stephanie Renee Fuller, MS, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP131525 Issued in TX

Practice address

5556 Cantabria Dr
Dallas, TX 75248-6445

Phone

(214) 405-5556

NPI assigned

Aug 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Fuller Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: stephanie.fuller.1@30520.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/HHFGDD
• FHIR API: https://fhir4.healow.com/fhir/r4/CHFABD

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.

• Modern Physician Services PC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1932590601
  Medicare reassignment Care Compare group NPD
• Divinity Medical Services PLLC

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment NPD
• Hicksville Family Medical Care, PLLC

  • Family Medicine Physician
  • Mineola, NY
  • NPI 1770813792
  Medicare reassignment NPD
• Park Avenue Pediatrics, P.C.

  • Pediatrics Physician
  • Spring Valley, NY
  • NPI 1699969543
  Medicare reassignment NPD
• Rockwell Health LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1699479733
  Medicare reassignment NPD
• Statcare Urgent & Walk in Medical Care PLLC

  • Urgent Care Clinic/Center
  • Mineola, NY
  • NPI 1336426667
  Medicare reassignment NPD
• The Partners Care

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1386093367

  Family

  Medicare reassignment NPD
• Stephanie Fuller NP in Family Health PC

  • Primary Care Clinic/Center
  • Hollis, NY
  • NPI 1538902663
  NPD Authorized official
• Ilyagu Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1730859935
  NPD (past)

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1780138305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HIGHWAY 3 S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733755",
            "telephone_number": "281-332-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 CANTABRIA DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752486445",
            "telephone_number": "214-405-5556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Highway 3 S",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775731527",
            "country_code": "US",
            "telephone_number": "214-405-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MS, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "FULLER",
            "credential": "MS, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelcie Denea Fuller
• Lakeshia Rena Fuller, RN
• Lauren Caroline Fuller
• Michelle L Fuller, NPC
• Natasha Lachine Fuller, MBA, QMHP-CS, PSS
• Timothy Fuller, MD
• Timothy Brandon Fuller, PRIMARY BENEFICIARY
• Fulllife Medical Supply
• Kylie Jeannine Fullner, DPT
• James Mark Fulmer, MD

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.