Nicky Fuller

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11003023 Issued in FL

Practice address

1 W Sample Rd Ste 103
Deerfield Beach, FL 33064-3547

Phone

(954) 942-6868

Fax

(954) 942-6854

NPI assigned

Jul 3, 2019

Sex

Female

Sole proprietor

Yes

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 FL

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nifuller@entaaf.emadirect.md

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.

• ENT and Allergy Associates of Florida, LLC

  • Otolaryngology Physician
  • Boca Raton, FL
  • NPI 1164473120

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• LT Health and Wellness LLC

  • Home Health Agency
  • Lauderdale Lakes, FL
  • NPI 1720694367
  NPD Authorized official

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1902468556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD STE 103",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-942-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD STE 103",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-942-6868",
            "fax_number": "954-942-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NICKY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003023",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Fuentes
• Patricia Fuentes
• Cheri Fugate-Fowler
• Corey Alicia Fuller
• Elizabeth Caroline Fuller
• Wynell Eunice Fuller, LCSW
• Cynthia Fulton-Solomon
• Deshawnta Fulton
• Joyce Funderburk
• Kyleigh Furey

• Family Nurse Practitioner in Deerfield Beach, FL
• Providers in Deerfield Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.