Justin Wayne Fuller

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

264564 Issued in AZ

Practice address

13677 W McDowell Rd
Goodyear, AZ 85395-2600

Phone

(602) 284-1903

NPI assigned

Aug 3, 2021

Last updated

Oct 15, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment Care Compare group NPD
• Banner - University Hospital Based Physicians LLC

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1750751566
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Arizona - Nogales

  • Certified Registered Nurse Anesthetist
  • Tucson, AZ
  • NPI 1487251799

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  Medicare reassignment NPD
• Anesthesia Partners of Arizona LLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1619452901

  AZ

  Medicare reassignment NPD
• Ascend Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
  • NPI 1407642945
  Medicare reassignment
• Banner - University Hospital Based Physicians LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1538879481
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1124374822
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD
• VHS Outpatient Clinics, Inc.

  dba Arizona Sports Medicine Center (ASMC)

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1891302790
  NPD

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

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1962176917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952600",
            "telephone_number": "972-761-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952600",
            "telephone_number": "602-284-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JUSTIN",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "264564",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN185391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresh Rain Counseling Center
• Lucia Maria Fronterotta, M.S.
• Megan Frye, RDN
• Ana Maria Fuentes, ACNP
• Daniel Elias Fuguet, M.D.
• Preston Joel Fulton, PHARMD
• Christopher Thomas Furey, OD, PLC
• Michael T Furey
• David Paul Furrow
• Karen D Gafford, PA

• Certified Registered Nurse Anesthetist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.