DR. STANLEY B. FULLER (NPI# 1437119302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437119302 |
| Entity Type | Individual |
| Full Name | DR. STANLEY B. FULLER |
| Credential | M.D. |
| Practice Address |
2825 Lyndhurst Ave Ste 101 Winston Salem NC 27103-4146 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3362774075 |
| Practice Fax Number | 3362774095 |
| Mailing Telephone | 3362774075 |
| Mailing Fax Number | 3362774095 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 34605 | NC | Allopathic & Osteopathic Physicians |
| Y | 208C00000X | Colon & Rectal Surgery | 34605 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC LLICENSE | 34605 | 01 |
| NC | 8934129 | 05 | |
| VA | 1437119302 | 05 | |
| NC | DEA NUMBER | BF 2917120 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653520 | Stanley Fuller | Marriage & Family Therapist | 170 9th St, San Francisco, CA 94103-2603 | 2018-09-18 |
| 1396034658 | Stanley R Fuller | Ophthalmology | 116 Minnie St, Fairbanks, AK 99701-3006 | 2011-04-06 |
| 1639344344 | Stanley B Fuller Sr. | Licensed Practical Nurse | 117 N Wayne St, 117 N Wayne St, Fremont, OH 43420-2431 | 2008-04-23 |
| Street Address |
2825 LYNDHURST AVE STE 101 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-4146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366781445 | Novant Medical Group, Inc. | Surgery | 2825 Lyndhurst Ave, Suite 101, Winston Salem, NC 27103-4146 | 2013-02-08 |
| 1932366705 | Roodabeh Samimi | Podiatrist | 2825 Lyndhurst Ave, Suite 105, Winston Salem, NC 27103-4146 | 2008-05-20 |
| 1568639961 | David Sindram | Surgery | 2825 Lyndhurst Ave, Ste 101, Winston Salem, NC 27103-4146 | 2008-05-14 |
| 1750416491 | Nicolas E Robinson | Surgery | 2825 Lyndhurst Ave, Ste 101, Winston Salem, NC 27103-4146 | 2007-02-22 |
| 1487667218 | Patricia K. Sauter | Nurse Practitioner | 2825 Lyndhurst Ave, Ste 101, Winston Salem, NC 27103-4146 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493239 | William Alfred Walker | Colon & Rectal Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1200 | 2005-11-04 |
| 1447861968 | Carolina Colon & Rectal Specialists Pa | Colon & Rectal Surgery | 3049 Senna Dr, Matthews, NC 28105-6727 | 2020-08-10 |
| 1295178986 | Melissa Silva Zoumberos | Colon & Rectal Surgery | 14 Medical Park Dr, Asheville, NC 28803 | 2013-04-11 |
| 1821358748 | Warqaa M Akram | Colon & Rectal Surgery | 600 Moye Blvd, Greenville, NC 27834-4300 | 2012-05-24 |
| 1285952002 | Benny Yee-chun Chong | Colon & Rectal Surgery | 200 Medical Park Dr, Suite 400, Concord, NC 28025-2982 | 2010-05-05 |
| 1629395579 | Nicole Chaumont | Colon & Rectal Surgery | 101 Manning Dr, Dept of Surgery Cb#7050, Chapel Hill, NC 27514 | 2010-04-30 |
| 1811166549 | Western Wake Surgical PC | Colon & Rectal Surgery | 155 Parkway Office Ct, Suite 101, Cary, NC 27518-7427 | 2008-02-27 |
| 1023296647 | Carolina Colorectal Surgery, PC | Colon & Rectal Surgery | 2501 Atrium Dr, Suite 305, Raleigh, NC 27607-6452 | 2008-02-06 |
| 1003937079 | Kevin Kasten | Colon & Rectal Surgery | 1025 Morehead Medical Dr, Ste 300, Charlotte, NC 28204-2963 | 2007-04-03 |
| 1497702773 | Edmund Rutherford J Rutherford | Colon & Rectal Surgery | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2006-05-30 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.