Kayla Rae Fuller, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306606334 Issued in VA

Practice address

1944 Centerville Tpke Ste 101
Virginia Beach, VA 23464-6839

Phone

(757) 271-4585

Fax

(833) 627-5148

NPI assigned

May 18, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Independence Physical Therapy LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1750037610

  Single Specialty

  NPD

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1245921345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 INDEPENDENCE BLVD STE B",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556200",
            "telephone_number": "757-917-5061",
            "fax_number": "757-904-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 CENTERVILLE TPKE STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646839",
            "telephone_number": "757-271-4585",
            "fax_number": "833-627-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KAYLA",
        "middle_name": "RAE",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Craig Fuhrmann, DDS
• Kristen L Fulcher, LCSW
• Full Swing Arm Care PLLC
• Briyah Marlene Fuller
• Javanese Fuller, MSW, QMHP-A
• Lorenzo Fuller Jr.
• Wayne Templeton Fuller, M.D.
• Neil Fullwood
• Christina Marie Fulmer
• Functional Health Revolution

• Physical Therapy Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.