Individual provider Active NPI

Kimberly M Fuller, NP

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1346123734
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024194022 Issued in VA
Practice address
736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone
(757) 609-3380
Fax
(757) 609-3384
NPI assigned
Jul 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024194022 VA Primary

Addresses

Primary practice location

736 Battlefield Blvd N
Chesapeake, VA 23320-4941

Mailing address

3241 Western Branch Blvd
Chesapeake, VA 23321-5260
Phone (757) 686-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925001845 VA Practitioner - Nurse Practitioner 9830694322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayview Physician Services PCGroup PAC ID 5597664201, 311 clinicians

Practice addresses (Care Compare)

612 Kingsborough SQ
Suite 200
Chesapeake, VA 23320-5054
Phone (757) 842-4120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024194022VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Sep 1, 2025 Accepting new patients
Bayview Physician Services, PC CurrentSince Sep 1, 2025 Accepting new patients
Bayview Physician Services, PC Past Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

612 Kingsborough Sq
Ste 200
Chesapeake, VA 23320
Phone (757) 436-0167

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1346123734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 WESTERN BRANCH BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215260",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BATTLEFIELD BLVD N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204941",
            "telephone_number": "757-609-3380",
            "fax_number": "757-609-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024194022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.