Jonathan Fuller, STUDENT

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN2384182 Issued in MA

Practice address

330 Brookline Ave
Boston, MA 02215-5491

Phone

(617) 667-3112

Fax

(617) 754-8791

NPI assigned

Jan 8, 2024

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1407626617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-3112",
            "fax_number": "617-754-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-3112",
            "fax_number": "617-754-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JONATHAN",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2384182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Fuller, LCSW
• Catherine Mary Fuller, BCBA
• Emma F Fuller, PA-C
• Grace Elizabeth Fuller, MD
• Jon D. Fuller, MD
• Madeline Rachel Fuller, MD
• Mark Joseph Fuller Jr., MT-BC, NMT
• Matthew Paul Fuller, PA-C
• Meredith Ann Fuller
• Quanesha Alunte Fuller, LCSW

• Certified Registered Nurse Anesthetist in Boston, MA
• Providers in Boston, MA by specialty
• Certified Registered Nurse Anesthetist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.