Sara G Fuller, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN1042 Issued in SC

Practice address

2638 Two Notch Rd
Suite 110
Columbia, SC 29204-1454

Phone

(803) 256-2500

Fax

(803) 255-3451

NPI assigned

May 18, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1871546226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK RD",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038003",
            "telephone_number": "803-255-3422",
            "fax_number": "803-255-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 TWO NOTCH RD",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041454",
            "telephone_number": "803-256-2500",
            "fax_number": "803-255-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SARA",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "APN1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0171",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Tyson Fuller, D.M.D.
• Isaac Fuller
• Jasmine Fuller, RBT
• Megan Fuller, MA
• Ross Fuller
• Tiffany Case Fuller
• Carolyn W Fulmore, LPC
• Brandi N/a Fulton, RN
• Darlene Fulton
• David B. Fulton, M.D.

• Pediatric Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.