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Active NPI 1215801865 Individual Practitioner Male Practitioner

Greg L. Fullmer , AGNP-C

Nurse Practitioner - Gerontology • Spokane, WA

Professional Overview & Biography Verified Profile Summary

Greg Fullmer, AGNP-C is a registered healthcare professional specializing in Nurse Practitioner - Gerontology in Spokane, WA. Practice services are available at 4815 N ASSEMBLY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4815 N Assembly St

Spokane, WA 992056185

Telephone 5094347000
Associated Practice Facility / Clinic
🏢 Spokane Vamc Facility NPI 1962450122

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Gerontology in Spokane, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.9 Yrs
State Avg: 8.3 Yrs
Regional Practice Density
15 Specialists

Practicing in Spokane, WA (210 Statewide)

Telehealth Adoption Rate
13.3% 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

CMS Verified: 2025-09-10
Nurse Practitioner - Gerontology Primary Specialty

NUCC Taxonomy Code: 363LG0600X

State License ID 5271681

Definition to come...

Practice Associates & Co-Workers

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

40 Associated Practitioners
Jeffrey Bailey , RN

Clinical Nurse Specialist - Psychiatric/Mental Health

NPI 1003502808

Registered Nurse

Mayson Harrison , LMSW, LSWAIC

Student in an Organized Health Care Education/Training Program

NPI 1003622119

Licensed Master Social Worker, LSWAIC

NPI 1003738253

Doctor of Optometry

Nikolus Richey , PA-C

Physician Assistant - Medical

NPI 1023598265

Physician Assistant (Certified)

Dr. Brandy Henson , PhD

Psychologist - Clinical

NPI 1033303425

Doctor of Philosophy (Ph.D.)

Sarah Newton

Hospitalist

NPI 1033506308

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active October 06, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location October 06, 2025

Registered at 4815 N ASSEMBLY ST, SPOKANE, WA 992056185 (Tel: 5094347000)

📍
Updated Business Mailing Address October 06, 2025

Registered at 803 E ELM AVE, COEUR D ALENE, ID 838144438 (Tel: 6194561337)

👤
Provider Name / Credentials Updated October 06, 2025

Recorded as GREG FULLMER, AGNP-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2025

Nurse Practitioner (License #5271681 in ID)

🟢
Initial NPI Registration & Enumeration October 06, 2025

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: 1215801865
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2025
Last Update: October 06, 2025
Sole Proprietor: Yes

Mailing Address

803 E Elm Ave

Coeur D Alene, ID 838144438

Phone: 6194561337

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.