Charles W Fuller, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F3971 Issued in TX

Practice address

1933 Pine St
Ste B
Abilene, TX 79601-2431

Phone

(325) 675-0338

Fax

(325) 676-5049

NPI assigned

Jun 27, 2005

Last updated

Aug 4, 2011By 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

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Charles W. Fuller, MD

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1508145871
  Authorized official Same address or phone
• Eastland Memorial Hospital District

  dba Eastland Memorial Hosptial

  • Medicare Defined Swing Bed Hospital Unit
  • Eastland, TX
  • NPI 1023353752
  NPD (past)
• Eastland Memorial Hospital District

  dba Eastland Memorial Hospital

  • General Acute Care Hospital
  • Eastland, TX
  • NPI 1689650921
  NPD (past)
• Hendrick Provider Network

  dba Hendrick Rural Health Clinic San Saba

  • Rural Health Clinic/Center
  • San Saba, TX
  • NPI 1346044401
  NPD (past)
• Hendrick Provider Network

  • Internal Medicine Physician
  • Abilene, TX
  • NPI 1396961322

  Family Medicine

  NPD (past)
• Serenity Foundation of Texas

  • Substance Abuse Rehabilitation Facility
  • Abilene, TX
  • NPI 1558333542
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1780680439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 PINE ST",
            "address_2": "STE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012431",
            "telephone_number": "325-675-0338",
            "fax_number": "325-676-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 PINE ST",
            "address_2": "STE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012431",
            "telephone_number": "325-675-0338",
            "fax_number": "325-676-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "F3971",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F3971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE HMO",
            "identifier": "113131101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140117607",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140117624",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Dale Friesenhahn, DDS
• Shawnta Fry, RN
• Marius Cevin Fryer, PHARMD
• Lori Denise Frymire, P.T.
• Irene Fuentes, LCSW
• Douglas B Fullerton, MD
• Tiffany Anne Fullerton
• Dale A Funk, M.D.
• Glen G Funkey, PT, DPT
• Kelly Raye Fussell, FNP

• Family Medicine Physician in Abilene, TX
• Providers in Abilene, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.