Rachel Ann Fuller, FNP
Individual provider Active NPI Family Nurse Practitioner · Grundy, VA
NPI 1922428697 · NPPES record last updated Aug 17, 2016
Key facts
- NPI
- 1922428697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024171662 (VA)
- Practice address
- 1532 Slate Creek Rd
Suite 101
Grundy, VA 24614-6975 - Phone
- (276) 935-2080
- Fax
- (276) 935-2082
- NPI assigned
- Apr 22, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140818000537 | VA | Practitioner - Nurse Practitioner | 2062639933 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024171662 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buchanan Health Center Inc | Current | Accepting new patients | |
| Buchanan Health Diabetes Center | Current |
Accepting new patients | |
| Physicians Care of Virginia PC | Current |
Accepting new patients | |
| Southeastern Physician Services PC | Current |
Accepting new patients | |
| St. Charles Health Council, Inc | Past | Accepting new patients |
Locations
15051 Harmony Hills Ln
Abingdon, VA 24211
Phone (276) 451-2590
2966 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-8144
1532 Slate Creek Rd
Ste 101
Grundy, VA 24614
Phone (276) 935-2080
2602 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 343-5968
600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024171662 | VA | Yes |
Addresses
Primary practice location
1532 Slate Creek Rd
Suite 101
Grundy, VA 24614-6975
Mailing address
119 Boone Ridge Dr
Ste 201
Johnson City, TN 37615-8000
Phone (276) 935-2080
Other providers in Grundy, VA
- Brian L Fields
- Amanda Fletcher
- Susan Buskill Fogg
- Samantha Renee Fraley
- Friendship Home Health Inc
- David Allen Gettman
- Haley Reed Gibson
- Janice Goff
- Maragret L Goss
- Aleshia Grizzle
All providers in Grundy, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.