Jeffrey S Fuller, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71002856A Issued in IN

Practice address

1406 W Bella Drive
Marion, IN 46953-5229

Phone

(765) 662-7720

Fax

(765) 573-5660

NPI assigned

Jan 28, 2009

Last updated

Oct 20, 2020By the provider in NPPES

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marion General Hospital Hospital, Marion, IN, CCN 150011

Merit-based Incentive Payment System (MIPS)

Final score

85.82 of 100Reported as group

Quality

71.45

Promoting interoperability

100

Improvement activities

40

Cost

75.59

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.fuller@mgh.eclinicaldirectplus.com

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.

• Marion General Hospital

  dba Physicians' Billing of MGH

  • Family Medicine Physician
  • Marion, IN
  • NPI 1528099041
  Medicare reassignment Care Compare group NPD
• Marion General Hospital

  dba Pediatric Center

  • Pediatrics Physician
  • Marion, IN
  • NPI 1346393204
  NPD
• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  NPD
• Union Healthcare Services Inc

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1013549468
  NPD
• Thrive Lagerkvist Medical Services, LLC

  • Family Medicine Physician
  • Marion, IN
  • NPI 1346533783
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Marion, IN
  • NPI 1770679201
  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Nutritional Support

  • Nutrition Support Registered Nurse
  • Marion, IN
  • NPI 1861578072

  Hospital

  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Ambulance Service

  • Land Ambulance
  • Marion, IN
  • NPI 1932295466

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1871731935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7600",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 W BELLA DRIVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535229",
            "telephone_number": "765-662-7720",
            "fax_number": "765-573-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002856A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000600494",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200929110",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.fuller@mgh.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1406 W Bella Drive",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469535229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelby D Fritz, M.A. CF-SLP
• Ashlyn Leigh Fry
• Jody Fry, LCSW
• Kelsi Fulda, FNP-C
• James O. Fuller, PH. D., LMHC
• Taylor Marie Gaillard
• Phillip Vincent Galeon
• Kenneth Edward Gallagher, MD
• Mary Joy Gallaway, DNP
• Leland Paul Gamson, LCSW

• Nurse Practitioner in Marion, IN
• Providers in Marion, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
• 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.