Kevin Powell Fuller I

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

271077801 Issued in PA

Practice address

1839 Zarker St
Harrisburg, PA 17104-1351

Phone

(717) 379-2546

NPI assigned

Oct 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Kevin Fuller Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1962737940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 ZARKER ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041351",
            "telephone_number": "717-379-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 ZARKER ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041351",
            "telephone_number": "717-379-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KEVIN",
        "middle_name": "POWELL",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "PA",
            "license": "271077801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271077801",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "FULLER",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Howard Fugate III, MD
• Jeffrey Stephen Fugate, DO
• Christina Kimiko Fuji, OTR/L
• Caitlin Fuller
• Jaden Fuller
• Jason Michael Fullmer, DC
• Adam Furfari, FNP-BC
• Breanna Furlong, DO
• Timothy D Futato, DMD
• Gabriel A Gabasan Jr., MD

• Home Health Aide in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Home Health Aide in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.