Lonnie Edward Fuller Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D73006 Issued in MD

Practice address

3700 Fleet St.
Suite 200
Baltimore, MD 21224

Phone

(410) 558-4900

Fax

(410) 522-1475

NPI assigned

Sep 20, 2006

Last updated

Nov 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Internal Medicine

Education

University of Texas Medical Branch at Galveston, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lfuller53895@gbmcdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greater Baltimore Medical Center, Inc

  dba GBMC Dept of OBGYN, L&D

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
  • NPI 1891855763
  Medicare reassignment Care Compare group NPD
• Greater Baltimore Medical Center, Inc.

  • General Practice Physician
  • Baltimore, MD
  • NPI 1396774238
  NPD
• Greater Baltimore Medical Center, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1538029731
  NPD
• Baltimore Medical System Inc

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1548266547
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Greater Baltimore Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1255372397
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1336246305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SINCLAIR LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132029",
            "telephone_number": "410-732-8800",
            "fax_number": "410-534-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FLEET ST.",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21224",
            "telephone_number": "410-558-4900",
            "fax_number": "410-522-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LONNIE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD041830L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D73006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001241798",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirely Cooper Fullard, MA, CCC-SLP
• Alice K Fuller, PA-C
• Benjamin Fuller
• Donald Jenkins Fuller, PA-C
• Jacqueline L Fuller
• Robert Fuller, MD
• Katelin Fullerton, LCSW-C
• Joshua Fullwood
• Kennedi Kirsten Fullwood
• Michael Alain Fulop, M.D.

• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.