HEIDI FULLER (NPI# 1730713173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730713173 |
| Entity Type | Individual |
| Full Name | HEIDI FULLER |
| Practice Address |
12121 Shelbyville Rd Ste 101 Louisville KY 40243-1094 |
| Practice Telephone | 5023411599 |
| Mailing Telephone | 5023411599 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | CRANIAL PROSTHESIS | 000965136 | 01 |
| MEDICAL SERVICES | 965136 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831628668 | Heidi Marie Fuller | Nurse Anesthetist, Certified Registered | 22 Bramhall St, Portland, ME 04102-3134 | 2017-06-06 |
| 1093246951 | Heidi Michelle Fuller | Student in an Organized Health Care Education/Training Program | 732 Harrison Ave, Podiatry Clinic 5th Floor, Boston, MA 02118-2309 | 2017-03-22 |
| Street Address |
12121 SHELBYVILLE RD STE 101 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40243-1094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942801949 | Pulsemer Health LLC | Clinic/Center | 11408 Shelbyville Rd, Suite 2, Louisville, KY 40243 | 2020-11-05 |
| 1316563372 | Molly Elizabeth Fitzgerald | Counselor | 350 Evergreen Road Suite 102, Louisville, KY 40243 | 2020-06-24 |
| 1215575410 | Eric Wolfe | Pharmacist | 1320 Snake Foot Drive, Apt 204, Louisville, KY 40243 | 2019-12-18 |
| 1417501974 | Joshua Bynum | Physical Therapist | 12935 Shelbyville Road Ste 106, Louisville, KY 40243 | 2019-08-01 |
| 1376013342 | Carmen Sue Frederick | Psychologist | 731 Speckman Road, Louisville, KY 40243 | 2018-12-03 |
| 1205366846 | Triple Crown Dentistry | Dentist | 904 Lily Creek Road, Suite 101, Louisville, KY 40243 | 2017-06-15 |
| 1659811636 | Jean Steltenpohl | Dietitian, Registered | 518 Cheskirk Pl, Louisville, KY 40243 | 2017-02-24 |
| 1548555287 | Jonathan D Senters | Pharmacist | 12975 Shelbyville Road, T-2728, Middletown, KY 40243 | 2011-06-10 |
| 1023339835 | Ashley Rose Havens | Speech-Language Pathologist | 11510 Main Street, Louisville, KY 40243 | 2010-06-15 |
| 1801110424 | Shawna L. Kauffman | Family Medicine | 12955 Shelbyville Rd Ste 2, Louisville, KY 40243 | 2010-03-25 |
| Find all providers in zip 40243 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225574817 | Wakefields Home Health & Improvement | Point of Service | 1108 Longfield Ave, Louisville, KY 40215-2728 | 2017-01-06 |
| 1851693139 | Lets Stay Home | Point of Service | 136 N Crestmoor Ave, Louisville, KY 40206-2735 | 2010-11-19 |
| 1871623520 | Fern Creek Traditional High School | Point of Service | 9115 Fern Creek Rd, Louisville, KY 40291-2711 | 2007-03-06 |
| 1396127452 | Albertsons Pharmacy | Point of Service | 910 W Cherry St, Louisville, CO 80027-3044 | 2015-06-25 |
| 1649576711 | John A Catapano | Point of Service | 3502 Dixie Hwy, Louisville, KY 40216-5069 | 2011-02-07 |
| 1659560035 | Champion Chiropractic, Inc | Point of Service | 332 W Broadway, #801, Louisville, KY 40202-2130 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639526940 | Children1st | Point of Service | 104 Holiday Court, Elizabethtown, KY 42701-8809 | 2016-05-17 |
| 1174987770 | Sears Holding - Kmart Pharmacy | Point of Service | 485 Norvell Rd, Corbin, KY 40701-6205 | 2016-04-09 |
| 1790175438 | Hendricks Family & Cosmetic Dentistry | Point of Service | 1025 Dove Run Rd Ste 208, Lexington, KY 40502-3588 | 2015-02-03 |
| 1871820290 | Honor Care LLC | Point of Service | 4215 Pleasant Valley Rd, Owensboro, KY 42303-9632 | 2009-11-05 |
| 1407075088 | Gentle Care Family Cosmetic Dentistry | Point of Service | 2558 Larkin Rd, Lexington, KY 40503-3205 | 2007-04-24 |
| 1740388511 | Carmen Renee Browning | Point of Service | 111 Minary Ave, Versailles, KY 40383-1329 | 2006-09-20 |
| 1285185587 | Zipclinic Urgent Care | Point of Service | 2508 Scottsville Rd, Suite 102, Bowling Green, KY 42104-4400 | 2016-10-21 |
| 1417374315 | Laurus | Point of Service | 2141 Spencer Ct, La Grange, KY 40031-6742 | 2014-03-28 |
| 1477889541 | Shaw Family Chiropractic Pllc | Point of Service | 1900 Greensburg Rd, Campbellsville, KY 42718-8448 | 2009-10-26 |
| 1871715300 | Baughman & Ewald, P.s.c. | Point of Service | 508 Fairdale Road, Fairdale, KY 40118 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | LOUISVILLE |
| Zip Code | 40243 |
Please comment or provide details below to improve the information on HEIDI FULLER.
| 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.