Individual provider Active NPI

Elizabeth W Fuller

  • Family Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1922177237
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-046393 Issued in AL
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone
(205) 348-1770
Fax
(205) 348-2593
NPI assigned
Nov 8, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-046393 AL Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070611000269 AL Practitioner - Nurse Practitioner 8426156704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phillip G. RobbinsGroup PAC ID 3274904750, 5 clinicians

Practice addresses (Care Compare)

108 5TH St NE
Aliceville, AL 35442-2200
Phone (205) 373-3945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-046393ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Health Services Foundation PC CurrentSince Feb 3, 2020 Accepting new patients
Aliceville Family Practice, LLC CurrentSince Oct 5, 2022 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Feb 3, 2020 Accepting new patients

Locations

108 5th St NE
Aliceville, AL 35442
Phone (205) 373-3945

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922177237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ELIZABETH",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-046393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.