Individual provider Active NPI

Randy G Fussell

  • Dentist
  • Greenville, NC
National Provider Identifier
1821049479
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5909 Issued in NC
Practice address
110 Oakmont Dr
Greenville, NC 27858-5936
Phone
(252) 355-2424
Fax
(252) 355-2701
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5909 NC Primary

Addresses

Primary practice location

110 Oakmont Dr
Greenville, NC 27858-5936

Mailing address

110 Oakmont Dr
Greenville, NC 27858-5936
Phone (252) 355-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200128002935 NC Practitioner - Dentist 8022329119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5909NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Nov 9, 2019 Accepting new patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince Nov 9, 2019 Accepting new patients
Lee, Fussell, Humphreys & Humphreys, P.a. Dentist Past Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 4

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821049479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OAKMONT DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585936",
            "telephone_number": "252-355-2424",
            "fax_number": "252-355-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OAKMONT DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585936",
            "telephone_number": "252-355-2424",
            "fax_number": "252-355-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "RANDY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "5909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.