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Active NPI 1497364053 Individual Practitioner Female Practitioner

Dr. Mary Fuller , DNP

Nurse Practitioner • Kewanee, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Mary Fuller, DNP is a certified Nurse Practitioner practicing in Kewanee, IL. With approximately 7 years of clinical experience since completing medical education in 2019, Dr. Fuller delivers high-quality medical care to the local community at 110 N BURR BLVD.

Dr. Fuller is affiliated with County Of Henry and accepts Medicare assignment.

Frequently performed procedures and clinical services include vaccine for influenza for administration into muscle, 0.5 ml dosage, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

110 N Burr Blvd

Kewanee, IL 614432214

Telephone 3098520197
Fax 3098545575
Associated Practice Facility / Clinic
🏢 County Of Henry Facility NPI 1851394829

Medicare Profile & Education

Medical School

Other

Graduation Year

2019

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Kewanee, IL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
7 Yrs -6.8 yrs vs City Avg
City Avg: 13.8 Yrs
State Avg: 10.4 Yrs
Regional Practice Density
7 Specialists

Practicing in Kewanee, IL (4929 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
22.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fuller (7 Years) 7 Yrs
Kewanee Specialty Average (13.8 Years) 13.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage
23 23 $30.00 $21.09
G0008 Administration of influenza virus vaccine
18 18 $10.00 $9.80

Medical Specialties & State Licenses

CMS Verified: 2020-08-04
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 209021513

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Preventive Medicine - Public Health & General Preventive Medicine

NUCC Taxonomy Code: 2083P0901X

State License IL 209021513

Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.

Nurse Practitioner - Primary Care

NUCC Taxonomy Code: 363LP2300X

State License IL 209021513

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
366006568001 (IL)

Hospital & Practice Group Affiliations

County Of Henry

110 N Burr Blvd, Kewanee, IL 614432214

Phone: 3098520197

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Stephanie Rusk

Registered Nurse

NPI 1104655489
Margaret Feurer , NURSE PRACTITIONER

Nurse Practitioner - Family

NPI 1114071842

NURSEPRACTITIONER

Amanda Rediger

Nurse Practitioner

NPI 1184356958
Marisa Murillo

Case Manager/Care Coordinator

NPI 1184453037
Emily Holton

Counselor - Mental Health

NPI 1386472660
Malissa Sanders

Licensed Practical Nurse

NPI 1760211049

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 04, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 04, 2020

Registered at 110 N BURR BLVD, KEWANEE, IL 614432214 (Tel: 3098520197)

📍
Updated Business Mailing Address August 04, 2020

Registered at 110 N BURR BLVD, KEWANEE, IL 614432214 (Tel: 3098520197)

👤
Provider Name / Credentials Updated August 04, 2020

Recorded as MARY FULLER, DNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2020

Preventive Medicine (License #209021513 in IL)

🟢
Initial NPI Registration & Enumeration July 29, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497364053
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 29, 2020
Last Update: August 04, 2020
Sole Proprietor: No

Mailing Address

110 N Burr Blvd

Kewanee, IL 614432214

Phone: 3098520197

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.