Active NPI
Brandon Fuller
- Physical Therapy Assistant
- Brewer, ME
National Provider Identifier
1023925831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PA6868
- Practice address
- 278 State St
Brewer, ME 04412-1519 - Phone
- (207) 922-4900
- NPI assigned
- Aug 26, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PA6868 | Primary |
Addresses
Primary practice location
278 State St
Brewer, ME 04412-1519
Mailing address
290 North Rd
Winterport, ME 04496-4601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1023925831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 NORTH RD",
"city": "WINTERPORT",
"state": "ME",
"postal_code": "044964601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 STATE ST",
"city": "BREWER",
"state": "ME",
"postal_code": "044121519",
"telephone_number": "207-922-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-08-26",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": "PA6868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewer, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.