Mr Timothy Louis Fuller, DO - Medicare Pediatrics in Greeneville, TN

Mr Timothy Louis Fuller, DO is a medicare enrolled "Pediatrics" physician in Greeneville, Tennessee. His current practice location is 428 East Vann Road, Greeneville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 278-1950.

Mr Timothy Louis Fuller is licensed to practice in Tennessee (license number 1343) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497822845.

Contact Information

Mr Timothy Louis Fuller, DO
428 East Vann Road,
Greeneville, TN 37743-7202
(423) 278-1950
(423) 278-1973



Physician's Profile

Full NameMr Timothy Louis Fuller
GenderMale
SpecialityPediatrics
Location428 East Vann Road, Greeneville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1497822845
  • Provider Enumeration Date: 11/29/2006
  • Last Update Date: 02/03/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 4385676337
  • Enrollment ID: I20171011002632

Medical Identifiers

Medical identifiers for Mr Timothy Louis Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1497822845NPI-NPPES
4121421OtherTNBCBST
TN01Q1OtherTNJD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 1343 (Tennessee)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Timothy Louis Fuller allows following entities to bill medicare on his behalf.
Entity NameBlue Ridge Medical Management Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144380833
PECOS PAC ID: 9739099441
Enrollment ID: O20031204000996

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Timothy Louis Fuller is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Timothy Louis Fuller, DO
Po Box 15004,
Knoxville, TN 37901

Ph: (865) 522-9730
Mr Timothy Louis Fuller, DO
428 East Vann Road,
Greeneville, TN 37743-7202

Ph: (423) 278-1950

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Pediatrics Doctors in Greeneville, TN

Mrs. Kelsey Jean Little, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 221 N Main St, Greeneville, TN 37745
Phone: 423-787-6050    Fax: 423-787-6054
Dr. Justin Alan Jones, D.O.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 428 E Vann Rd, Greeneville, TN 37743
Phone: 423-278-1950    
Todd William Aiken, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 428 E Vann Rd, Greeneville, TN 37743
Phone: 423-278-0950    Fax: 423-278-1973
Dr. John Applegate, DO
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 428 E Vann Rd, Greeneville, TN 37743
Phone: 423-278-1950    Fax: 423-278-1973
Douglas Catron Cobble, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 221 N Main St, Greeneville, TN 37745
Phone: 423-787-6050    Fax: 423-787-6054
Ms. Kimberly R Fisher, D.O.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 221 N Main St, Greeneville, TN 37745
Phone: 423-787-6050    Fax: 423-787-6054

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