JON D. FULLER (NPI# 1952387946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952387946 |
| Entity Type | Individual |
| Full Name | JON D. FULLER |
| Credential | MD |
| Practice Address |
725 Albany Street Shapiro 9, Suite B Boston MA 02118-2526 |
| Mailing Address |
720 Harrison Ave Dob 503 Boston MA 02118-2371 |
| Practice Telephone | 6174144290 |
| Practice Fax Number | 6174144285 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 70785 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110044024A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376566976 | Jon Gordon Fuller Jr. | Dentist | 570 W 400 N, Moab, UT 84532-2236 | 2006-07-25 |
| 1245270412 | Jon D Fuller | Internal Medicine | 3801 Miranda Ave., Va Palo Alto Hcs, Palo Alto, CA 94304 | 2006-06-07 |
| 1225080765 | Jon D Fuller | Surgery | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2006-05-16 |
| Street Address |
725 ALBANY STREET SHAPIRO 9, SUITE B |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699772715 | Theresa Clare Weir | Nurse Practitioner | 725 Albany Street, Shapiro 5 and 6, Boston, MA 02118-2526 | 2005-07-05 |
| 1588292114 | Alexander Lee Yeo | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Precepting Room, Boston, MA 02128 | 2020-03-30 |
| 1851928840 | Juan Vicente Rodriguez | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-27 |
| 1518594928 | Tyler Newshaw Lescure | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Precepting Room, Boston, MA 02128 | 2020-03-25 |
| 1548897929 | Luke Chmielecki | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Shapiro Primary Care, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1982231379 | Tina Zhang | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Precepting Room, Boston, MA 02128 | 2020-03-25 |
| 1619511482 | Amelia Hansen | Nurse Practitioner | 725 Albany Street, Shapiro 7, Suite B, Boston, MA 02118 | 2019-11-04 |
| 1821649153 | Mariah Barrows | Nurse Practitioner | 725 Albany Street, Shapiro 7, Suite C, Boston, MA 02118 | 2019-09-27 |
| 1750939112 | Arielle Davidson | Nurse Practitioner | 725 Albany Street, Shapiro 7, Suite B, Boston, MA 02118 | 2019-08-29 |
| 1619532272 | Opal Mahalia Mitchell | Nurse Practitioner | 725 Albany Street, Shapiro 7, Suite B, Boston, MA 02118 | 2019-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386260594 | Form Health Associates (ma), P.C. | Family Medicine | 179 Lincoln St Ste 404, Boston, MA 02111-2425 | 2020-06-23 |
| 1043835044 | Form Health Associates, P.C. | Family Medicine | 179 Lincoln St Fl 4, Boston, MA 02111-2424 | 2020-06-15 |
| 1578099404 | Medexpress Primary Care Massachusetts, P.C. | Family Medicine | 578 Huntington Ave Fl 2, Boston, MA 02115-5902 | 2017-05-11 |
| 1144761438 | Shravya Budidi | Family Medicine | 72 E Concord St # 2600, Boston, MA 02118-2642 | 2017-03-20 |
| 1942650106 | Morgan Younkin | Family Medicine | 801 Massachusetts Ave Fl 2, Boston, MA 02118-2605 | 2016-06-20 |
| 1205220126 | Brian T Kroener | Family Medicine | 1 Dowling Medical Center Place, Dowling 5, Boston, MA 02119-2908 | 2015-03-28 |
| 1093129488 | Maya Yasmin Mauch | Family Medicine | South End Community Health Center, 1601 Washington St., Boston, MA 02118 | 2014-06-13 |
| 1528478500 | Maria Joan Bachman | Family Medicine | Boston Medical Center, 1 Bmc Place, Department of Family Medicine / Dowling 5, Boston, MA 02118 | 2014-04-30 |
| 1154680668 | Brian Robert Clear | Family Medicine | 68 Harrison Ave Fl 6, Boston, MA 02111-1929 | 2012-05-04 |
| 1861750333 | Jessica R Gray | Family Medicine | 720 Harrison Ave., Dob 503, Boston, MA 02118 | 2012-05-02 |
| Find all providers in BOSTON | ||||
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| 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.