Linda Jo Fuller, D.O.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

H0065164 Issued in MD

Practice address

751 Twinbrook Pkwy Ste 2
Rockville, MD 20851-1499

Phone

(240) 777-1680

Fax

(240) 777-3381

NPI assigned

Oct 30, 2008

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1225281546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 TWINBROOK PKWY STE 2",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208511499",
            "telephone_number": "240-777-1680",
            "fax_number": "240-777-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 TWINBROOK PKWY STE 2",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208511499",
            "telephone_number": "240-777-1680",
            "fax_number": "240-777-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LINDA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "H0065164",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MD",
            "license": "H0065164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shodo Fukuzawa, RPH
• Kiera Fulcher
• Jonathan Karim Fullah
• Deborah Marlene Fuller, LCSW-C
• Kiesha Fuller
• Sha'Ron Fuller
• Virginia Jean Fulton, NP
• Alexia Funchess
• Functional Physical Therapy, LLC
• Nyla Funderburk

• Addiction Psychiatry Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Addiction Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.