Individual provider Active NPI

Valerie J Fuller, RN, FNP-C

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1790879682
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP81373 Issued in ME
Practice address
22 Bramhall Street
Portland, ME 04102
Phone
(207) 662-4078
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R048123 ME
Family Nurse Practitioner 363LF0000X CNP81373 ME Primary

Addresses

Primary practice location

22 Bramhall Street
Portland, ME 04102

Mailing address

8 Streamwood Lane
Falmouth, ME 04105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20141003001074 ME Practitioner - Nurse Practitioner 5597985044 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
CNP81373MEMDFamily Nurse Practitioner
R048123MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Jul 30, 2018 Accepting new patients
Maine Medical Partners Family Current Accepting new patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Central Maine Medical Center CurrentSince Jul 30, 2018 Accepting new patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Providence Health & Services Oregon Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 6B
Portland, ME 04102

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: vfuller31087@direct.mmc.mainehealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1790879682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 STREAMWOOD LANE",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "04105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "VALERIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R048123",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.