Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1679751937 Deactivated / Inactive NPI Female Practitioner

Kosara Adzemovic Fuller , SLP

Speech-Language Pathologist • Charlotte, NC

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kosara Fuller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 07, 2008
NPI Deactivation Date July 07, 2017
Total Practice Duration ~9 Years of Practice (2008 – 2017)

Professional Overview & Biography Verified Profile Summary

Kosara Fuller, SLP was a registered Speech-Language Pathologist practicing in Charlotte, NC. Throughout an active medical career spanning 9 years, Kosara Fuller provided care at the practice location at 3800 SHAMROCK DR until profile deactivation on 2017-07-07.

Practice Location & Contact Primary Location

Practice Address

3800 Shamrock Dr

Charlotte, NC 282153220

Telephone 7045325364
Associated Practice Facility / Clinic
🏢 Genesis Rehab Facility NPI 1679808240

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Charlotte, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.6 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
698 Specialists

Practicing in Charlotte, NC (7242 Statewide)

Telehealth Adoption Rate
0.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NC 2468

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.

Practice Associates & Co-Workers

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

17 Associated Practitioners
Deborah Klinedinst , PT

Physical Therapist

NPI 1053437863

Physical Therapist

Dolores Cruz , PTA

Physical Therapy Assistant

NPI 1093047276

Physical Therapist Assistant

Rebecca Nesbitt , MS

Occupational Therapist

NPI 1134252497

Master of Science

Lorie Aldridge , LPTA

Physical Therapy Assistant

NPI 1225155104

Licensed Physical Therapist Assistant

Melissa Baker , PTA

Physical Therapy Assistant

NPI 1235433038

Physical Therapist Assistant

Dr. Tiffany Colinco , DPT

Physical Therapist

NPI 1417284068

Doctor of Physical Therapy

Career & Practice History Timeline

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

7 Historical Events
⚠️
NPI Profile Deactivated July 07, 2017

Record deactivated on July 07, 2017

NPI Profile Active February 07, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location February 07, 2008

Registered at 3800 SHAMROCK DR, CHARLOTTE, NC 282153220 (Tel: 7045325364)

📍
Updated Business Mailing Address February 07, 2008

Registered at 7308 WALTERBORO RD, CHARLOTTE, NC 282271233 (Tel: 7045017290)

👤
Provider Name / Credentials Updated February 07, 2008

Recorded as KOSARA FULLER, SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2008

Speech-Language Pathologist (License #2468 in NC)

🟢
Initial NPI Registration & Enumeration February 07, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kosara Fuller. Be the first to share your experience!

Sign in to leave a review for Kosara Fuller

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1679751937
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2008
Last Update: February 07, 2008
Deactivation Date: July 07, 2017

Mailing Address

7308 Walterboro Rd

Charlotte, NC 282271233

Phone: 7045017290

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.