Individual provider Active NPI

Nathaniel Asbury Fuller, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1912330945
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3019 N Center St
Hickory, NC 28601-1160
Phone
(706) 910-6708
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3019 N Center St
Hickory, NC 28601-1160

Mailing address

6521 Buena Vista CT
Hickory, NC 28601-9416
Phone (706) 651-2369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20171122002330 NC Practitioner - Physician Assistant 4587894514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gandn Medical, PLLCGroup PAC ID 1557864113, 4 clinicians
Frye Emergency Medical Associates LLCGroup PAC ID 1557398609, 18 clinicians

Practice addresses (Care Compare)

3019 N Ctr St
Hickory, NC 28601-1160
Phone (706) 910-6708

420 N Ctr St
Hickory, NC 28601-5033
Phone (704) 660-4055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
G&N Medical, PLLC CurrentSince Sep 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nathanielfullerhigherlevel@docvilladirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1912330945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6521 BUENA VISTA CT",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286019416",
            "telephone_number": "706-651-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286011160",
            "telephone_number": "706-910-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NATHANIEL",
        "middle_name": "ASBURY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.