JONATHAN FULLER (NPI# 1801229745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801229745 |
Entity Type | Individual |
Full Name | JONATHAN FULLER |
Credential | PA |
Practice Address |
915 Gordon Ave Rm 206208 Thomasville GA 31792-6614 |
Mailing Address |
3560 W Pinetree Blvd Thomasville GA 31792-8822 |
Practice Telephone | 2292282799 |
Mailing Telephone | 8504450918 |
Enumeration Date | 2013-08-14 |
Last Update Date | 2019-06-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013315001 | Jonathan H Fuller | Family Medicine | 1401 Rainbow Dr Ste B, Gadsden, AL 35901-5319 | 2014-12-08 |
1992260756 | Jonathan Fuller | Behavior Technician | 505 E Commonwealth Ave, Fullerton, CA 92832-4009 | 2019-02-06 |
1659872786 | Jonathan Fuller | Behavior Technician | 27777 Inkster Rd, Farmington Hills, MI 48334 | 2018-02-23 |
1053314443 | Jonathan Ellis Fuller | Orthopaedic Surgery | 13616 California St, Ste 100, Omaha, NE 68154-5335 | 2005-05-31 |
Street Address |
915 GORDON AVE RM 206208 |
City | THOMASVILLE |
State | GA |
Zip Code | 31792-6614 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902888357 | Elvin Coy Irvin Jr. | Family Medicine | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2005-11-18 |
1104459692 | Sallie Daniele Bussey | Nurse Practitioner | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2020-02-13 |
1023658697 | Melinda Greene | Occupational Therapist | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2020-01-13 |
1346714540 | Kenneth Daniel Anders | Physical Therapy Assistant | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2019-01-22 |
1902372550 | Lauren Taylor Froede | Nurse Practitioner | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2018-10-22 |
1821563354 | Mckayla B Noble | Anesthesiologist Assistant | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2018-10-11 |
1619442753 | Jennifer Breen Mills | Nurse Practitioner | 915 Gordon Ave, Thomasville, GA 31792-6699 | 2018-10-04 |
1457836520 | Donald Bruhn | Anesthesiologist Assistant | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2018-09-25 |
1205355419 | Anna Noteman Petrey | Nurse Practitioner | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2017-09-19 |
1174043590 | Robert Anello | Dietitian, Registered | 915 Gordon Ave, Thomasville, GA 31792-6614 | 2017-06-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
Find all providers in zip 31792 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730168030 | Valerie L Bush | Physician Assistant | 100 Mimosa Dr 2nd Floor, Thomasville, GA 31792-6676 | 2006-01-13 |
1679062442 | Jonathan Heidkamp | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792-4875 | 2018-05-07 |
1184120818 | Catherine W Howell | Physician Assistant | 334 Smith Ave, Thomasville, GA 31792-5533 | 2018-04-02 |
1205334737 | Katherine Love Edelen | Physician Assistant | 100 S Madison St, Thomasville, GA 31792-5473 | 2018-01-30 |
1356877328 | Edie Willis | Physician Assistant | 334 Smith Ave, Thomasville, GA 31792-5533 | 2017-05-11 |
1922453158 | Waqas Tariq | Physician Assistant | 207 Old Lexington Rd, Thomasville, NC 27360-3428 | 2016-04-25 |
1063892974 | Deuel Mcelreath Iv | Physician Assistant | 334 Smith Ave, Thomasville, GA 31792-5533 | 2015-06-05 |
1689827255 | Mary E Woolfolk | Physician Assistant | 1102 Smith Ave, Thomasville, GA 31792-5739 | 2008-10-28 |
1669509196 | Robert Lee Bradford | Physician Assistant | 508 Gordon Ave, Thomasville, GA 31792-6646 | 2007-02-28 |
1073698031 | Ronald Lindquist | Physician Assistant | 112 Mimosa Dr, Thomasville, GA 31792-6605 | 2006-10-26 |
Find all providers in THOMASVILLE |
City | THOMASVILLE |
Zip Code | 31792 |
Please comment or provide details below to improve the information on JONATHAN FULLER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.