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PEGGY A FULLER MD
NPI 1598871345
Specialist in Charlotte, NC

Active since August 22, 2006Opted out of Medicare · through Oct 2, 2027
353 CLEMENT AVE, CHARLOTTE, NC 28204(704) 370-2700(704) 370-2702 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Peggy A Fuller Md NPPES

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

PEGGY A FULLER MD (NPI 1598871345) is an individual specialist in Charlotte, North Carolina, licensed in North Carolina (9700555) and active in the NPI registry since August 2006. She has opted out of Medicare through October 2, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1598871345
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NamePEGGY A FULLERCredential: MD
Location Address353 CLEMENT AVECharlotte, NC 28204-2431
Mailing Address353 Clement AveCharlotte, NC 28204-2431 · (704) 370-2700 · Fax (704) 370-2702
Phone(704) 370-2700
Fax(704) 370-2702
Sole ProprietorYes
Enumeration DateAugust 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1598871345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NC · 9700555
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
353 CLEMENT AVE, Charlotte, NC 28204
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Other Identifiers 2

Medicare UPING52520
Other9700555NC · State License Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Peggy A Fuller Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 2, 2017 through October 2, 2027.

Opt-Out Effective DateOctober 2, 2017
Opt-Out In Effect ThroughOctober 2, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

ESTHETICS CENTER FOR DERMATOLOGY PA
Specialist
353 CLEMENT AVE
CHARLOTTE, NC 28204
Mecklenburg County (704) 370-2700

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 Peggy Fuller's NPI number?

The NPI number for Peggy Fuller is 1598871345. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Peggy Fuller located?

Peggy Fuller practices at 353 Clement Ave, Charlotte, NC 28204. The listed phone number is (704) 370-2700.

What is Peggy Fuller's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Peggy Fuller enrolled in Medicare?

No. Peggy Fuller has opted out of Medicare through October 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Peggy Fuller was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.