DR. SEAN DOUGLAS FULLER MD NPI 1063488054

NPI Information

  • NPI: 1063488054
  • Provider Name: DR. SEAN DOUGLAS FULLER, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7182 WOODROW ST STE 200
    IRMO, SC
    ZIP 29063
  • Phone: (803) 749-1111

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NPI Details

DR. Sean Douglas Fuller, MD is a family medicine in Irmo, SC with 21 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Sean Douglas Fuller, MD NPI is 1063488054. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduation Year:2005

The provider's business location address is:

7182 WOODROW ST STE 200
IRMO, SC
ZIP 29063-958
Phone: (803) 749-1111
Fax: (803) 749-0050

The NPI 1063488054 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99490)
  • Advance care planning, first 30 minutes (HCPCS:99497)
  • Annual alcohol misuse screening, 15 minutes (HCPCS:G0442)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Annual depression screening, 15 minutes (HCPCS:G0444)
  • Injection, ceftriaxone sodium, per 250 mg (HCPCS:J0696)
  • Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes (HCPCS:G0446)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Automated urinalysis test (HCPCS:81003)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Face-to-face behavioral counseling for obesity, 15 minutes (HCPCS:G0447)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99439)
  • Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)
  • Removal of fingernails or toenails, 1-5 nails (HCPCS:11720)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)

The enumeration date for this NPI number is 2/28/2006 and was last updated on 2/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine20144SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201445MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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