MIMI O FULLER (NPI# 1326155128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326155128 |
| Entity Type | Individual |
| Full Name | MIMI O FULLER |
| Credential | CNA |
| Practice Address |
735 E Main Street Spartanburg SC 29302-1281 |
| Practice Telephone | 8645421308 |
| Mailing Telephone | 8645421308 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | AANA22356 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | SCAPN987 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | AN0665 | 05 |
| Street Address |
735 E MAIN STREET |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922067420 | Cheryl Lynn Schosky | Nurse Anesthetist, Certified Registered | 101 E. Wood St., Spartanburg, SC 29303 | 2006-03-22 |
| 1427027812 | Wendy Stanton Weston | Nurse Anesthetist, Certified Registered | 101 E Wood St., Spartanburg, SC 29303 | 2006-03-16 |
| 1982687091 | Deborah Lou Hilburn | Nurse Anesthetist, Certified Registered | 157 S Pine St, Spartanburg, SC 29302-1936 | 2005-11-22 |
| 1982229704 | Kathryn Dewalt Rubel | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1962026096 | Justin Brent Brooks | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-04 |
| 1942824487 | Marla Caufield | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-01 |
| 1528682200 | Amanda Lyons St. Marie | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-05-29 |
| 1003463472 | Adam Raynes | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2019-08-21 |
| 1396302840 | Meghan Rahcael Breil | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2019-05-21 |
| 1851956841 | Jamie Lynne Mason | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2019-05-06 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
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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.