Brad Edward Fuller, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.096344 Issued in OH

Practice address

625 Africa Rd Ste 300
Westerville, OH 43082-9830

Phone

(614) 882-9460

Fax

(614) 882-9802

NPI assigned

Mar 25, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bfuller19093@copcp.medicity.net

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.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194
  Medicare reassignment
• Central Ohio Primary Care Physicians Inc

  • Hospitalist Physician
  • Westerville, OH
  • NPI 1518398866
  NPD

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1104068949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829830",
            "telephone_number": "614-882-9460",
            "fax_number": "614-882-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829830",
            "telephone_number": "614-882-9460",
            "fax_number": "614-882-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRAD",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.096344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061071",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fries Eye Care, LLC
• Nana Agyeman Frimpong
• Karin Jane Fronk
• Heather Augusta Alberta Fuhrman, MD
• Matthew Christopher Fullen, LPCC
• Brooke Fuller, MSLP, CCC-SLP
• Camille Gisella Fuller
• Kathleen T Fulop, MD
• Bradley J. Fulton, D.D.S.
• James Allen Fultz Jr., DDS

• Pediatrics Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.