Active NPI
Colin Wyatt Fuller, M.D.
- Pediatric Otolaryngology Physician
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Otolaryngology Physician
- License
- W4468
- Practice address
- 1500 Cooper St
Fort Worth, TX 76104-2710 - Phone
- (682) 885-6850
- Fax
- (682) 885-6799
- NPI assigned
- Jun 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Otolaryngology Physician | 207YP0228X | W4468 | TX | Primary |
| Pediatric Otolaryngology Physician | 207YP0228X | 67805 | OK | |
| Otolaryngology Physician | 207Y00000X | 6781 | GA |
Addresses
Primary practice location
1500 Cooper St
Fort Worth, TX 76104-2710
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cfuller258384@CookChildrens.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700
900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065
Hospital & facility affiliations
- O U Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6781 | GA | MD | Otolaryngology Physician |
| 67805 | OK | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ou Health Partners, Inc | Current | Accepting new patients | |
| Ou Health Partners, Inc | Current | Accepting new patients | |
| Ou Medicine Inc. | Past | Accepting new patients |
Locations
1200 Childrens Ave
Oklahoma City, OK 73104
Phone (405) 271-2429
900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230
1122 NE 13th St
#274
Oklahoma City, OK 73117
Interoperability endpoints
- cfuller22257@ouhealth.direct-ci.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Oklahoma City, OK
- NPI 1528642642
-
- Prosthetic/Orthotic Supplier
- Oklahoma City, OK
- NPI 1447834460
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1649794157
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1649794157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1922413343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 733784",
"city": "DALLAS",
"state": "TX",
"postal_code": "753733784",
"telephone_number": "682-885-6483",
"fax_number": "682-303-7132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 COOPER ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042710",
"telephone_number": "682-885-6850",
"fax_number": "682-885-6799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "COLIN",
"middle_name": "WYATT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-24",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "TX",
"license": "W4468",
"primary": true
},
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "OK",
"license": "67805",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "GA",
"license": "6781",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cfuller258384@CookChildrens.direct-ci.com",
"affiliation": "N",
"address_1": "1500 Cooper St",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761042710",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.