Jeremy D Fuller, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

21688 Issued in WV

Practice address

1340 Hal Greer Blvd
Huntington, WV 25701-3804

Phone

(304) 526-2200

Fax

(304) 399-6726

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

JC Edwards School of Medicine, Marshall University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cabell Huntington Hospital IncGroup PAC ID 3274436340, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.fuller@direct.chhi.org

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.

• Cabell Huntington Hospital Inc

  • Anesthesiology Physician
  • Huntington, WV
  • NPI 1275576373
  Medicare reassignment Care Compare group NPD
• Occumed, LLC

  • Urgent Care Clinic/Center
  • Huntington, WV
  • NPI 1639289937

  Family Medicine

  Medicare reassignment NPD
• University Physicians & Surgeons, Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1730183286
  Medicare reassignment
• Cabell Huntington Hospital Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1659456234

  Emergency Medicine

  NPD
• Cabell Huntington Hospital Inc

  • Home Health Agency
  • Huntington, WV
  • NPI 1669558904
  NPD

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

• Cabell Huntington Hospital Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1073518007
  Care Compare affiliation

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285713156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-526-2200",
            "fax_number": "304-399-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-526-2200",
            "fax_number": "304-399-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Stonecrest Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257019391",
            "country_code": "US",
            "telephone_number": "304-525-2273",
            "fax_number": "304-525-2165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JEREMY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21688",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP578",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WV",
            "license": "21688",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "21688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100048840",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285713156",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2783519",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeremy.fuller@direct.chhi.org",
            "affiliation": "N",
            "address_1": "1340 Hal Greer Blvd",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melody G. Frye, LPC
• Bryan Fugate
• Gilbert Michael Fulks, RPH
• A Nedra Yulonda Fuller Terry, DPM
• Debra Jane Fuller-Phelps, MA, MS, LSW
• Jillian Fuller
• Katelen Fuller
• Kenneth Fuller
• Tammey Fuller, R.N.
• G & R LLC

• Emergency Medicine Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• 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.