Meredith Ann Fuller

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7368 Issued in MA

Practice address

123 W Concord St
Apt. 2
Boston, MA 02118-1507

Phone

(617) 838-6035

NPI assigned

Nov 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1346420205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "WEST FALMOUTH",
            "state": "MA",
            "postal_code": "025740350",
            "telephone_number": "617-838-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W CONCORD ST",
            "address_2": "APT. 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181507",
            "telephone_number": "617-838-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MEREDITH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W05847",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon D. Fuller, MD
• Jonathan Fuller, STUDENT
• Madeline Rachel Fuller, MD
• Mark Joseph Fuller Jr., MT-BC, NMT
• Matthew Paul Fuller, PA-C
• Quanesha Alunte Fuller, LCSW
• Daniel Jeremy Fulop
• Anne B Fulton, MD
• David Fulton, MD
• Linnea Elisabeth Fulton, PA-C

• Clinical Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.