Tamara L. Fusco, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2000158302 Issued in MO

Practice address

940 W Mount Vernon St
Suite 220
Nixa, MO 65714-9609

Phone

(417) 724-5437

Fax

(417) 724-5433

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

No

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.

• Burrell, Inc.

  • Community/Behavioral Health Agency
  • Springfield, MO
  • NPI 1275541740
  Medicare reassignment MO
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MO

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2025.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1821163528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 220",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149609",
            "telephone_number": "417-724-5437",
            "fax_number": "417-724-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Bradford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044264",
            "country_code": "US",
            "telephone_number": "417-761-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "TAMARA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2000158302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205017908",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Food Merchants LLC
• Food Merchants, LLC
• Food Merchants, LLC
• Kelly L. Fournier, CPM
• Katelyn Michelle Fulwider
• Garrett Edward Gabel, DC
• Caleb Allen Garde
• Jennifer Garner, DPT
• Erin Elizabeth Gdovin, PLPC
• Hannah Giefer, SLP

• All providers in Nixa, MO
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.