NPI: 1760871842

GARRICK FULLER, LMSW

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• Entity Type: Individual (Gender: M)
• Last Observed in the System¹ on:
• First Entered in the System¹ on: 2015-01-13
• Medicare Revalidation Due Date²: Not Available
• Certified the records on: Not Certified
• Specialty: Clinical Social Worker
• NPPES Profile Page: https://npiregistry.cms.hhs.gov/provider-view/1760871842
• CMS Profile Page: https://data.cms.gov/tools/medicare-physician-other-practitioner-look-up-tool/provider/1760871842

Medicare Order and Referring Eligibility

• Update Date: 2024-09-16; the data is from the CMS site.
• Part B Referral: Y
• Durable Medical Equipment Order: Y
• Home Health Referral: N
• Power Mobility Device Referral: N
• Hospice Referral: N

Other IDs

• PECOS ID: 2961851613

Affiliations

The affiliation information is derived from the Medicare revalidation list².

• Alaska Advanced Behavioral Health (1043993801)

Addresses

• Primary & Current, 607 DIVISION ST, NOME, AK 997620966

Taxonomies

• 2018-01-07 ~ Present ³ , Clinical Social Worker (1041C0700X), Primary

Notes

1. https://nppes.cms.hhs.gov/#/
2. https://data.cms.gov/tools/medicare-revalidation-list
3. Our records go back to 2018-01-07, and any records preceding this date are not captured. Please regard 2018-01-07 as the earliest date we could verify the records back then, not as the actual date for the time range.
4. https://openpaymentsdata.cms.gov/
5. The information is based on the UnitedHealthcare Transparency in Coverage site.