Fuller Vision, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FULLER VISION, LLC

Doing business as

Gulf Coast Vision

Practice address

2170 E Pass Rd Ste a
Gulfport, MS 39507-3864

Phone

(601) 382-4365

NPI assigned

Aug 18, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jay Andrew Fuller, O.D.NPI 1053667758

Title

Doctor

Phone

(228) 262-0266

Specialties & licenses 1

Addresses

Other names 1

• Gulf Coast Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay Fuller, O.D.

  • Optometrist
  • Gulfport, MS
  • NPI 1053667758
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1215655915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 E PASS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073864",
            "telephone_number": "228-262-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 E PASS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073864",
            "telephone_number": "601-382-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "228-262-0266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gulf Coast Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn Eric Friedland, MD
• Alaina Granier Frierson, DDS
• Jocelyn Frierson, PT
• Christopher P Frigo, D.D.S.
• Timothy Chad Frye, CRNP
• Jay Fuller, O.D.
• Eva Funches, CSFA
• Jessica Fuqua, NP-C
• Charles Benjamin Furlan Jr., MD
• Stephanie Fussell, M.D.

• Optometrist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.