JONATHAN FULLER


Address: 915 Gordon Ave, Rm 206208, Thomasville, GA 31792-6614
Phone: 2292282799

JONATHAN FULLER (NPI# 1801229745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Other Providers JONATHAN FULLER

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

Office Location

Street Address 915 GORDON AVE
RM 206208
City THOMASVILLE
State GA
Zip Code 31792-6614

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City THOMASVILLE
Zip Code 31792

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Dataset Information

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.

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