Nikol Fuller, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95006169 Issued in CA

Practice address

290 N Wayte LN # 1300
Fresno, CA 93701-2124

Phone

(866) 342-6012

NPI assigned

Jan 24, 2017

Last updated

Jan 14, 2020By 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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nikol.fuller.1@17661.direct.athenahealth.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.

• Central California Faculty Medical Group, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1457603573
  Medicare reassignment NPD
• University Faculty Associates, Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1073911137
  Medicare reassignment
• Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1992742852
  NPD

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1891232252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 N WAYTE LN # 1300",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012124",
            "telephone_number": "866-342-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NIKOL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006169",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95006169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Araujanae Fuller
• Cajanae Fuller
• Eve Renee Fuller, RN, LVN
• Imonni J Fuller
• Marcus Fuller, LCSW
• Tammy Lynn Fuller
• Toccara La'Janda Fuller, RN
• Shawncai Fulsom
• Tracy Ann Fulton, LMFT
• Functional Industrial Rehabilitation Medical Associates Inc

• Pediatric Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.