Scott Edward Fuller, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH1564 Issued in MA

Practice address

3 Baldwin Green CMN Ste 207
Woburn, MA 01801-1869

Phone

(781) 933-3332

NPI assigned

Feb 8, 2006

Sex

Male

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 7

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fuller Chiropractic, PC

  • Chiropractor
  • Woburn, MA
  • NPI 1831337427
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1871566232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BALDWIN GREEN CMN STE 207",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011869",
            "telephone_number": "781-933-3332",
            "fax_number": "781-933-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BALDWIN GREEN CMN STE 207",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011869",
            "telephone_number": "781-933-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SCOTT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "CH1564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "1611577",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4494653",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "Y36107",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1001665",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0027013",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE SYSTEMS",
            "identifier": "4494653",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA127819",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Woburn, MA
• Providers in Woburn, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.