Noel Phillips Fuller, D.M.D, P.A

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

1799 Issued in SC

Practice address

1380 Ebenezer Rd
Rock Hill, SC 29732

Phone

(803) 324-2919

Fax

(803) 324-2918

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Apex Dental PA

  • General Practice Dentistry
  • Rock Hill, SC
  • NPI 1992211007
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871679852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323391",
            "telephone_number": "803-324-2919",
            "fax_number": "803-324-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-324-2919",
            "fax_number": "803-324-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NOEL",
        "middle_name": "PHILLIPS",
        "name_prefix": "Dr.",
        "credential": "D.M.D, P.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "1799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie N Fruit
• Fruitful Living Now LLC
• Georgette Thomasina Fuhr, MSW, LCSW, LISW-CP
• Megan Killmeyer Fuller
• Melody Rene Fuller
• Fullife Hope Center
• Robert V. Fulmer, MD
• Vonda Fulton, RBT
• Joy Doner Furchner, MSPT
• Ebony Futrell

• Endodontics in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.