Redgy Fuller, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

8055 Issued in NE

Practice address

984150 Nebraska Medical Ctr
Omaha, NE 68198-4150

Phone

(402) 559-4081

Fax

(402) 559-7372

NPI assigned

Jul 2, 2015

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 NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pain Management

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Innovative Pain and Spine SpecialistsGroup PAC ID 6406146083, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Innovative Pain & Spine Specialists

  • Interventional Pain Medicine Physician
  • Lincoln, NE
  • NPI 1245692581
  Medicare reassignment Care Compare group NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment Care Compare group NPD

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Nebraska Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation
• The Nebraska Medical Center

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891178372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984150",
            "telephone_number": "402-559-4081",
            "fax_number": "402-559-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984150",
            "telephone_number": "402-559-4081",
            "fax_number": "402-559-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "REDGY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "8055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destane Fuller
• Emily Fuller
• George Fuller
• Jessica Fuller, LIMHP, NCC, LPC
• Jonathan Ellis Fuller, M.D.
• Shayona Fuller
• Tayler Danyelle Fuller, DDS
• Tyreshia Fuller
• Nathan Fullinfaw
• Fulton Homes Assisted Living

• Anesthesiology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Anesthesiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.