Kathryn Elisabeth Fuller, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5019945 Issued in NC

Practice address

3610 Peters CT
High Point, NC 27265-9004

Phone

(336) 883-0029

Fax

(336) 883-0867

NPI assigned

May 14, 2022

Last updated

Jul 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathrynfuller@bethanymed.allscriptsdirect.net

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.

• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Bethany Medical Center PA

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1740381581

  Family Medicine

  NPD
• Bethany Medical Center, PA

  • Family Medicine Physician
  • High Point, NC
  • NPI 1508459306
  NPD
• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1255880571

  Family Medicine

  NPD (past)
• Bethany Medical Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Kernersville, NC
  • NPI 1619398997
  NPD (past)
• Bethany Medical Center, PA

  • Cardiovascular Disease Physician
  • High Point, NC
  • NPI 1174722391
  NPD (past)
• Southern Charm Family Healthcare

  • Family Medicine Physician
  • Richland, MS
  • NPI 1801471172
  NPD (past)

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

{
    "created_epoch": "1652486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1881331593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PETERS CT",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659004",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-0867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Skeet Club Rd",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272659530",
            "country_code": "US",
            "telephone_number": "336-883-0002",
            "fax_number": "336-883-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KATHRYN",
        "middle_name": "ELISABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-14",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019945",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "5019945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Patricia Fricke, LCSWA
• Claire Catherine Friederick, MD
• Mark S Frieze, PA
• Justin Fuchs
• Virginia Elizabeth Fulbright, PA-C
• Audra Calloway Fulp, EMT
• Ellen Heath Fulp, PHARM.D.
• Kimberly Fulp, M.A., CCC-SLP
• G. Chris Holdaway, DDS, PA
• Tony Anthony Gaddy

• Nurse Practitioner in High Point, NC
• Providers in High Point, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.