Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrew Mackenzie Fuller, CF-SLP

Individual provider Speech-Language Pathologist · NPI 1295303196

Andrew Mackenzie Fuller, CF-SLP is a Qualified Speech Language Pathologist in Las Vegas, Nevada. Qualified in 2021, 5 years ago. Practices with Functional Pathways Preferred of Tennessee LLC, a 192-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2021
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Practice location Address checks out

10401 W Charleston Blvd
Las Vegas, NV 89135-1151
Phone: (702) 207-4242
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2202011795 (VA)

Record details

NPI number1295303196
Entity typeIndividual (Type 1)
GenderMale
Credentials CF-SLP
Sole proprietorYes
NPI enumeratedJune 16, 2021
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Functional Pathways Preferred Of Tennessee Llc — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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