NPIMap

Individual provider Active NPI

Amanda Ruth Fuller, FNP-BC

  • Family Nurse Practitioner
  • Huntingdon, TN
National Provider Identifier
1891048765
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17089 Issued in TN
Practice address
3493 Veterans Dr N Ste C
Huntingdon, TN 38344-6230
Phone
(731) 986-2933
Fax
(731) 986-2938
NPI assigned
Oct 17, 2012
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17089 TN Primary

Addresses

Primary practice location

3493 Veterans Dr N Ste C
Huntingdon, TN 38344-6230

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 226-4003

Other practice location 1

631 Rb Wilson Dr
Huntingdon, TN 38344-1727
Phone (731) 986-7021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121205000167 TN Practitioner - Nurse Practitioner 4880846450 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evans Medical Clinic, PLLCGroup PAC ID 3870772817, 7 clinicians

Practice addresses (Care Compare)

3493 Veterans Dr N
Suite C
Huntingdon, TN 38344-6230
Phone (731) 986-2933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Tennessee Ear Nose & Throat CurrentSince Oct 17, 2012 Accepting new patients
Henry County Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Eagle Creek Emergency Group, PC Nurse Practitioner CurrentSince Jan 10, 2021 Accepting new patients
Henry County Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Evans Medical Clinic, PLLC CurrentSince Jun 18, 2018 Accepting new patients

Locations

787 Weatherly Dr
Ste 200
Clarksville, TN 37043
Phone (931) 647-1255

3493 Veterans Dr N
Ste C
Huntingdon, TN 38344
Phone (731) 668-4455

1015 Kelley Dr
Ste 200
Paris, TN 38242
Phone (731) 644-2271

300 Hospital Cir
Ste 200
Paris, TN 38242
Phone (731) 644-8460

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Interoperability endpoints

  • Direct secure messaging: afuller23363@direct.bmhcc.org
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1891048765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-226-4003",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 VETERANS DR N STE C",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383446230",
            "telephone_number": "731-986-2933",
            "fax_number": "731-986-2938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Rb Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383441727",
            "country_code": "US",
            "telephone_number": "731-986-7021",
            "fax_number": "731-986-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "AMANDA",
        "middle_name": "RUTH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, TN

Sources for this page

Verify at the official NPI Registry.