DR. THOMAS CHARLES FULLER (NPI# 1598705675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598705675 |
| Entity Type | Individual |
| Full Name | DR. THOMAS CHARLES FULLER |
| Credential | PHD |
| Practice Address |
161 Ottawa Nw Ste 300c Grand Rapids MI 49503-2707 |
| Mailing Address |
161 Ottawa Nw Ste 300c Human Resource Associates Grand Rapids MI 49503 |
| Practice Telephone | 6164580692 |
| Practice Fax Number | 6164588129 |
| Mailing Telephone | 6164580692 |
| Mailing Fax Number | 6164588129 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2011-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6301006879 | MI | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 6301006879 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457788697 | Thomas Scott Fuller | Anesthesiologist Assistant | 650 Wood Valley Trce, Roswell, GA 30076-2672 | 2013-10-02 |
| 1295052199 | Thomas Neal Fuller | Nurse Anesthetist, Certified Registered | 7131 Arlington Rd Apt 208, Bethesda, MD 20814-2918 | 2010-05-01 |
| 1154379766 | Thomas Fuller | Optometrist | 2b Haw Creek Ln, Asheville, NC 28805-2250 | 2006-05-05 |
| 1972865335 | Thomas William Fuller | Urology | 1100 9th Ave, Seattle, WA 98101-2756 | 2012-06-12 |
| 1083809057 | Thomas Fuller | Case Manager/Care Coordinator | 218 Dogwood Hollow Rd, Mountain View, AR 72560-7942 | 2007-09-12 |
| 1992808885 | Thomas A Fuller | Internal Medicine | 2816 E 116th St, Metrohealth Buckeye Health Center, Cleveland, OH 44120-2111 | 2006-09-06 |
| 1952348583 | Thomas Edward Fuller | Pharmacist | 223 N Main St, Marion, SC 29571-3025 | 2006-06-01 |
| 1508848961 | Thomas R Fuller | Radiology | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2005-11-18 |
| Street Address |
161 OTTAWA NW STE 300C |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-2707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841609369 | Crystal Young | Clinical Neuropsychologist | 1550 E Beltline Ave Se, Suite 340, Grand Rapids, MI 49506-4301 | 2014-08-08 |
| 1861686784 | Lauren Elizabeth Spoon | Clinical Neuropsychologist | 3333 36th St Se, Grand Rapids, MI 49512-2809 | 2007-09-04 |
| 1538287495 | James Bernard De Boe | Clinical Neuropsychologist | 4131 Embassy Dr Se, Grand Rapids, MI 49546-2418 | 2007-03-27 |
| 1891867495 | Cherry Street Services, Inc. | Clinical Neuropsychologist | 669 Stocking Ave Nw, Grand Rapids, MI 49504-5176 | 2006-11-15 |
| 1477663599 | Don Allen Boyd | Clinical Neuropsychologist | 3300 Burton St Se Ste B, Grand Rapids, MI 49546-4398 | 2006-08-30 |
| 1447738877 | Draycen Decator | Clinical Neuropsychologist | 3292 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 | 2018-07-28 |
| 1144717604 | Jaclyn Reckow | Clinical Neuropsychologist | 245 Cherry St Se Ste 104, Grand Rapids, MI 49503-4607 | 2018-04-19 |
| 1184172496 | Jesse J Piehl | Clinical Neuropsychologist | 3292 Evergreen Dr Ne, Grand Rapids, MI 49525-9580 | 2016-09-15 |
| 1144678020 | Alicia Beth Vanden Bussche Jantz | Clinical Neuropsychologist | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2016-06-01 |
| 1619346285 | Brianne Alyse Brooker | Clinical Neuropsychologist | 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503-2530 | 2015-09-24 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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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.