Anne B Fullmer, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

N-38467 Issued in ID

Practice address

709 N Lincoln Ave
Jerome, ID 83338-1851

Phone

(208) 814-9772

NPI assigned

Oct 6, 2015

Last updated

Oct 6, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Visions Home Health & Visions Home Care LLC Home health agency, Twin Falls, ID, CCN 137107
• Heritage Home Health Home health agency, Pocatello, ID, CCN 137117
• Heritage Hospice Hospice, Pocatello, ID, CCN 131568
• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke's Jerome Hospital, Jerome, ID, CCN 131310
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afullmer30846@direct.slhs.org

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.

• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Heritage Home Health LLC

  • Home Health Agency
  • Pocatello, ID
  • NPI 1396074027
  Care Compare affiliation
• Heritage Home Health, LLC

  dba Heritage Hospice

  • Community Based Hospice Care Agency
  • Pocatello, ID
  • NPI 1629319280
  Care Compare affiliation
• St Luke's Magic Valley Regional Medical Center LTD

  dba St Luke's Jerome

  • Critical Access Hospital
  • Jerome, ID
  • NPI 1366874877
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St. Luke's Magic Valley Regional Medical Center, LTD.

  dba St Lukes Magic Valley - Air Ambulance

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation
• Visions Home Health & Visions Home Care, LLC

  dba Visions Home Health

  • Home Health Agency
  • Twin Falls, ID
  • NPI 1235137761
  Care Compare affiliation

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1891165569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381851",
            "telephone_number": "208-814-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381851",
            "telephone_number": "208-814-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "ANNE",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "N-38467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Services Corporation
• Family Health Services Corporation (Family Health Services - Diabetic Education)
• Family Health Services Corporation (Family Health Services)
• Family Health Services Pharmacy
• Anna Fox, MD
• Kellsy Teresa Gallup, M.S., LPC
• Alexandria M Gandiaga
• Daniel Joe Garza
• Peter A Gibbons, PHARMD
• Jolynn Lesa Gilmore

• Family Nurse Practitioner in Jerome, ID
• Providers in Jerome, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.