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ANDREW MACKENZIE FULLER CF-SLP
NPI 1295303196
Speech-Language Pathologist in Las Vegas, NV

Active since June 16, 2021Accepts Medicare Assignment
10401 W CHARLESTON BLVD, LAS VEGAS, NV 89135(702) 207-4242 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 20, 2026, Jun 16, 2021 (2 updates tracked since 2021).

About Andrew Mackenzie Fuller Cf-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW MACKENZIE FULLER CF-SLP (NPI 1295303196) is an individual speech-language pathologist provider in Las Vegas, Nevada, licensed in Virginia (2202011795) and active in the NPI registry since June 2021. He is a graduate of Other (2021).

NPPES Registry Identity

NPI1295303196
Entity TypeIndividualMale
Primary Taxonomy235Z00000X
Provider Legal NameANDREW MACKENZIE FULLERCredential: CF-SLP
Location Address10401 W CHARLESTON BLVDLas Vegas, NV 89135-1151
Mailing Address935 Keswick BlvdLouisville, KY 40217-2136 · (502) 341-9369
Phone(702) 207-4242
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJune 16, 2021
Last NPPES UpdateApril 20, 20262 updates tracked since enumeration
NPPES CertifiedApril 20, 2026
✔ NPI 1295303196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in VA · 2202011795
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
10401 W CHARLESTON BLVD, Las Vegas, NV 89135
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew Mackenzie Fuller Cf-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800361908
PECOS Enrollment IDI20260407000575, I20260409001875

Medicare Billing Reassignment

Medicare enrollment records show Andrew Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Functional Pathways Preferred Of Tennessee LLC
1,739 mi
Physical Therapist
10133 SHERRILL BLVD, SUITE 200
Knoxville, TN 37932
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 94 clinicians in this Medicare group
NPI 1841561446 (888) 531-2204

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ASHISH PATEL
Physical Therapist
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 360-3662
INTERNATIONAL HEALING AND HYPERBARIC LTD
Emergency Medicine (Undersea and Hyperbaric Medicine)
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 576-9820
MAUREEN JOYCE BAUTO
Physical Therapy Assistant
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 207-4242
REYMUNDO MACABABBAD II OTR/L
Occupational Therapist
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 360-2662
ALLISON PALMER NP LLC
Community/Behavioral Health
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 207-4242
SANDRA CALVILLO
Social Worker (Clinical)
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 207-4242
ALEX CHEVEZ OTR
Occupational Therapist
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 207-4242
KEVIN DERRICK LUCE PTA
Physical Therapy Assistant
10401 W CHARLESTON BLVD
LAS VEGAS, NV 89135
Clark County (702) 207-4242

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Fuller's NPI number?

The NPI number for Andrew Fuller is 1295303196. It was assigned to this individual provider in the NPPES registry on June 16, 2021.

Where is Andrew Fuller located?

Andrew Fuller practices at 10401 W Charleston Blvd, Las Vegas, NV 89135. The listed phone number is (702) 207-4242.

What is Andrew Fuller's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Andrew Fuller enrolled in Medicare?

Yes. Andrew Fuller is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Andrew Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Fuller reassigns Medicare benefits to Functional Pathways Preferred Of Tennessee LLC (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrew Fuller was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.