Keydella Fuller, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11012620 Issued in FL

Practice address

Uf Health
15255 Max Leggett Parkway, Suite 3600
Jacksonville, FL 32218

Phone

(904) 383-1011

Fax

(904) 383-1411

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfuller539992@direct.shands.ufl.edu
• FHIR API: https://api.platform.athenahealth.com/25920/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  Medicare reassignment NPD
• NP Xperience LLC

  • Family Medicine Physician
  • Old Bridge, NJ
  • NPI 1225774367
  Medicare reassignment NPD
• Fuller Health & Wellness, LLC

  • Family Nurse Practitioner
  • Fernandina Beach, FL
  • NPI 1699649772
  NPD Authorized official
• University of Florida Jacksonville Physicians Inc

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1851551121
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Toms River Cardiovascular Institute LLC

  • Interventional Cardiology Physician
  • Toms River, NJ
  • NPI 1669899399
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1053855809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15255 MAX LEGGETT PKWY STE 3600",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187279",
            "telephone_number": "904-383-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UF HEALTH",
            "address_2": "15255 MAX LEGGETT PARKWAY, SUITE 3600",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-383-1011",
            "fax_number": "904-383-1411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 S 8th St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320343771",
            "country_code": "US",
            "telephone_number": "904-895-6433",
            "fax_number": "866-422-4441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KEYDELLA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012620",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00692900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuller Rehabilitation and Consulting Services, Inc.
• Christopher Fuller, PT, DPT
• Christopher Marshall Fuller
• Erica Fuller, OTR/L
• Julie Fuller, LMT
• Kimberly J Fuller, NP
• Lisa Fuller
• Mallory Fuller, M.A.
• Morgan E Fuller
• Jordan D'Ann Fullerton, PA-C

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.