Individual provider Active NPI

Lisa Fuller, NP-C

  • Family Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1932531928
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
768961 Issued in TX
Practice address
3201 University Dr E Ste 340
Bryan, TX 77802-3484
Phone
(979) 690-4808
Fax
(979) 690-4809
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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 768961 TX Primary

Addresses

Primary practice location

3201 University Dr E Ste 340
Bryan, TX 77802-3484

Mailing address

3201 University Dr E Ste 340
Bryan, TX 77802-3484
Phone (979) 690-4808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20131014000483 TX Practitioner - Nurse Practitioner 3971737693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

3201 University Dr E
Suite 340
Bryan, TX 77802-3484
Phone (979) 690-4808

Hospital & facility affiliations

  • A Nurses Touch Home Health Home health agency, Bryan, TX, CCN 747824
  • Traditions Health Home health agency, College Station, TX, CCN 457877
  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
768961TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family CurrentSince Sep 1, 2014 Accepting new patients
St Joseph Regional Health Center CurrentSince Sep 1, 2014 Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

3201 University Dr E
Ste 340
Bryan, TX 77802
Phone (979) 690-4808

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

2410 Boonville Rd
Bryan, TX 77808
Phone (979) 690-4808

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Interoperability endpoints

  • Direct secure messaging: lisa.fuller@sjrhc.eclinicaldirectplus.com
  • Direct secure messaging: lfuller456605@direct.stlukeshealth.org

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.

Hospital & facility affiliations 4

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": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1932531928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 340",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023484",
            "telephone_number": "979-690-4808",
            "fax_number": "979-690-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 340",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023484",
            "telephone_number": "979-690-4808",
            "fax_number": "979-690-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LISA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "768961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.