MR. RAYMOND LYNNWOOD FULLER JR. (NPI# 1639374408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639374408 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND LYNNWOOD FULLER JR. |
| Credential | D.O. |
| Practice Address |
353 New Shackle Island Rd Suite 245c Hendersonville TN 37075-2379 |
| Practice Telephone | 6158262265 |
| Practice Fax Number | 6158264616 |
| Mailing Telephone | 6158262265 |
| Mailing Fax Number | 6158264616 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2009-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | DO967 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS | 4040982 | 01 |
| TN | 3378274 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073836250 | Raymond Everett Fuller | Internal Medicine | 15 Andre St Se, Grand Rapids, MI 49507-3010 | 2010-03-02 |
| 1356424899 | Raymond D. Fuller | Surgery | 90 E William St, Delaware, OH 43015-2149 | 2006-10-20 |
| Street Address |
353 NEW SHACKLE ISLAND RD SUITE 245C |
| City | HENDERSONVILLE |
| State | TN |
| Zip Code | 37075-2379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536468 | Muhammad Asad | Internal Medicine | 353 New Shackle Island Rd, Suite 300 C, Hendersonville, TN 37075-2379 | 2005-05-23 |
| 1104442037 | Dustin Cross | Nurse Practitioner | 353 New Shackle Island Rd, Hendersonville, TN 37075-2379 | 2020-06-16 |
| 1225563307 | Clayton Thomas Anderson | Nurse Practitioner | 353 New Shackle Island Rd, Suite #300c, Hendersonville, TN 37075-2379 | 2017-04-26 |
| 1578003109 | Laura Rhea Smith | Physical Therapist | 353 New Shackle Island Rd, 142c, Hendersonville, TN 37075-2379 | 2017-03-01 |
| 1609319136 | Kara Earthman | Nurse Practitioner | 353 New Shackle Island Rd, Suite 221b, Hendersonville, TN 37075-2379 | 2016-12-01 |
| 1194272930 | Emily C Fitzpatrick | Nurse Practitioner | 353 New Shackle Island Rd, Suite 122b, Hendersonville, TN 37075-2379 | 2016-09-09 |
| 1982158176 | Lake Spine Consultants LLC | Orthopaedic Surgery | 353 New Shackle Island Rd, Suite 141c, Hendersonville, TN 37075-2379 | 2016-08-05 |
| 1336692904 | Enjoli Gupton | Nurse Practitioner | 353 New Shackle Island Rd, 300c, Hendersonville, TN 37075-2379 | 2016-07-29 |
| 1821442963 | Kaci Goodgame | Nutritionist | 353 New Shackle Island Rd, Suite 122 B, Hendersonville, TN 37075-2379 | 2016-04-14 |
| 1659730117 | Kelly Victoria Tyus | Audiologist | 353 New Shackle Island Rd, Suite 202-a, Hendersonville, TN 37075-2379 | 2016-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667425 | Results-ast Jv, LLC | Physical Therapist | 326 New Shackle Island Rd, Suite 300, Hendersonville, TN 37075 | 2020-10-21 |
| 1871126524 | Jessica Elise Williams | Nurse Practitioner | 100 Indian Lake Blvd, Hendersonville, TN 37075 | 2020-02-20 |
| 1003379108 | Infusion Express of Tennessee, PC | Clinic/Center | 1006 Glenbrook Way, Ste 130, Hendersonville, TN 37075 | 2019-04-08 |
| 1417414335 | Red Owl Industries, LLC | Chiropractor | 16 Executive Park Dr # 100, Hendersonville, TN 37075 | 2019-02-27 |
| 1992203368 | Cassie Berman | Occupational Therapist | 209 Shivel Drive, Hendersonville, TN 37075 | 2018-01-31 |
| 1407379373 | Hendersonville Smiles Dentistry, PC | Dentist | 1002 Glenbrook Way, Suite 200, Hendersonville, TN 37075 | 2017-07-21 |
| 1215483466 | Ryan Escue | Registered Nurse | 4221 Harding Pike, Nashville, TN 37075 | 2016-08-28 |
| 1003279589 | Grant Anderson | Physician Assistant | 211 Indian Lake Bloulevard, Hendersonville, TN 37075 | 2016-04-01 |
| 1073974192 | Jennifer Kramer | Nurse Practitioner | 103 Hazel Path Ct, Suite 7, Hendersonville, TN 37075 | 2016-03-16 |
| 1144680315 | Catherine Alexandria Wellendorf | Specialist/Technologist | 3126 Long Hollow Pike, Hendersonville, TN 37075 | 2016-03-02 |
| Find all providers in zip 37075 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578001608 | Usac-3 LLC | Internal Medicine | 174 Saundersville Rd, Hendersonville, TN 37075-8945 | 2017-02-09 |
| 1598194284 | Park Hill Medicine, Pa | Internal Medicine | 510 Park Hill Court, Hendersonville, NC 28739-4265 | 2013-11-04 |
| 1093977621 | Michael N Corradetti | Internal Medicine | 805 6th Ave W, Hendersonville, NC 28739-4137 | 2008-06-25 |
| 1285796367 | Felicia Browne Brabham | Internal Medicine | 510 Fleming St Ste C, Hendersonville, NC 28739-4250 | 2006-12-14 |
| 1144305152 | Robert Eric Jackson | Internal Medicine | 291 Indian Lake Blvd, Hendersonville, TN 37075-3653 | 2006-10-26 |
| 1013009729 | Hailu T Kabtimer | Internal Medicine | 919 W Main St M3, Hendersonville, TN 37075 | 2006-09-29 |
| 1083718639 | Edward Keith Bentson | Internal Medicine | 1895 Pisgah Dr, Hendersonville, NC 28791-3760 | 2006-09-12 |
| 1346264900 | Lateef Abumoussa | Internal Medicine | 510 Park Hill Ct, Hendersonville, NC 28739-4265 | 2006-07-27 |
| 1073537072 | Tadron Wilson | Internal Medicine | 351 New Shackle Island Rd, Hendersonville, TN 37075 | 2006-07-26 |
| 1649206582 | Eduardo Balcells | Internal Medicine | 709 N Justice St Ste A, Hendersonville, NC 28791-3455 | 2006-06-23 |
| Find all providers in HENDERSONVILLE | ||||
| City | HENDERSONVILLE |
| Zip Code | 37075 |
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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.