NICHOLE LESHAWN FULLER – Acute Care Nurse Practitioner, NPI 1720584899

NICHOLE LESHAWN FULLER is a healthcare provider. based in Rochester hills, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704280454 (MI). The NPI Number for NICHOLE LESHAWN FULLER is 1720584899

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLE LESHAWN FULLER
NPI
1720584899
Phone
(313) 492-8911
Address
1428 LEUPP CT
Enumeration Date
5 April 2018
Last Update Date
5 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3139937777
Graduation Year
2017 (9 years ago)
PAC ID
5597190447
Group Practice PAC ID
1850587890
Professional Enrollment ID
I20200122003168
Address ID
MI482012021DE4160XSTXX404
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:8State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

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Provider Addresses for NICHOLE LESHAWN FULLER

  • Leupp Court, Rochester Hills, Oakland County, Michigan, 48307, United States

    ROCHESTER HILLS, MI 483073021

    Phone: (313) 492-8911

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 105 Open Payments records for all available years, with a total value of $2,348.

Total Amount is formed as General ($2,348) + Research ($0) + Ownership ($0) = $2,348.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Kestra Medical Technology Services, Inc. ($343).

Total Amount

$2,348

General + Research + Ownership

Payments

105

Total payment records

General Amount

$2,348

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-01-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200122003168INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48307)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850587890View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology), Internal MedicineMI
Internal Medicine, Cardiovascular Disease (Cardiology)MI
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineMI
Cardiovascular Disease (Cardiology)MI
Physician AssistantMI
Internal MedicineMI
Nurse PractitionerMI
Physician AssistantMI
Interventional CardiologyMI
Internal Medicine, Interventional CardiologyMI

Reviews

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Frequently asked questions

How do I look up NICHOLE LESHAWN FULLER by NPI?
Use NPI 1720584899 when you need to reference NICHOLE LESHAWN FULLER in forms, claims, or directories.
Is NICHOLE LESHAWN FULLER currently active in the NPI registry?
CMS-published data lists NICHOLE LESHAWN FULLER as an active registrant.
What field does NICHOLE LESHAWN FULLER work in?
You can think of NICHOLE LESHAWN FULLER as practicing within Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for NICHOLE LESHAWN FULLER?
We surface Rochester Hills, Michigan for NICHOLE LESHAWN FULLER based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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