A Nedra Yulonda Fuller Terry, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

10387 Issued in WV

Practice address

2828 First Avenue
Suite 203
Huntington, WV 25702-1236

Phone

(304) 522-3692

Fax

(304) 522-3693

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. A Nedra Yulonda Fuller Terry Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1902976863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 FIRST AVENUE",
            "address_2": "SUITE 203",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-522-3692",
            "fax_number": "304-522-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 FIRST AVENUE",
            "address_2": "SUITE 203",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-522-3692",
            "fax_number": "304-522-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER TERRY",
        "first_name": "A NEDRA",
        "middle_name": "YULONDA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "10387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00357027",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810007238",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2707084",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A NEDRA",
            "last_name": "FULLER TERRY",
            "middle_name": "YULONDA",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cheri Frye
• Hadassah D Frye, MD
• Melody G. Frye, LPC
• Bryan Fugate
• Gilbert Michael Fulks, RPH
• Debra Jane Fuller-Phelps, MA, MS, LSW
• Jeremy D Fuller, MD
• Jillian Fuller
• Katelen Fuller
• Kenneth Fuller

• Podiatrist in Huntington, WV
• Providers in Huntington, WV by specialty
• Podiatrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.