Nino Fuller, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP140425 Issued in TX

Practice address

300 Wilson St
Henderson, TX 75652-5956

Phone

(903) 655-6536

NPI assigned

Dec 20, 2018

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, VA, GA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Texas Health Arlington Memorial Hospital Hospital, Arlington, TX, CCN 450064
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfuller836261@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• North Texas Physician Services, PLLC

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1992586150

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Texas, PA

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1992722953

  Nurse Practitioner

  Medicare reassignment NPD
• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429
  Medicare reassignment NPD
• Sound Inpatient Physicians of Texas I, Inc

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1831424563
  Medicare reassignment NPD
• Ingleside Physician Services, LLC

  • Hospitalist Physician
  • Low Moor, VA
  • NPI 1932693488

  Nurse Practitioner

  Medicare reassignment NPD
• Kingsford Physician Services, LLC

  • Hospitalist Physician
  • Pulaski, VA
  • NPI 1871088526

  Nurse Practitioner

  Medicare reassignment NPD
• Lake Spring Physician Services, LLC

  • Hospitalist Physician
  • Salem, VA
  • NPI 1568954287

  Nurse Practitioner

  Medicare reassignment NPD
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Nurse Practitioner

  Medicare reassignment NPD
• Wildwood Physician Services, LLC

  • Emergency Medicine Physician
  • Blacksburg, VA
  • NPI 1629560917

  Nurse Practitioner

  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Henderson Hospital, LLC

  dba UTHealth East Texas Henderson Hospital

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Texas Health Arlington Memorial Hospital

  • General Acute Care Hospital
  • Arlington, TX
  • NPI 1174533343
  Care Compare affiliation

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1962974469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-655-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-655-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NINO",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024180028",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140425",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP140425",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "GAA-NP000340",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "866207",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024180028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ola Marie Franklin, OTR
• Deborah Franks, CFNP
• Elwanda French, CRNA
• Corneil Kimberly Fretty, DDS
• Frio Hospital District (Autumn Leaves Nursing and Rehab)
• Furqueron & Jackson Dentistry Partnership (Henderson Family Dentistry)
• Sharavana Kumar Gajapathi, D.D.S, M.P.H
• Gibson & Harshaw, LLC (AssistCare)
• Robert Joseph Griffith, FNP-C
• Mark A Hackbarth, MD

• Nurse Practitioner in Henderson, TX
• Providers in Henderson, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.

Verify at the official NPI Registry.