Fuller-Roberts Clinic, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

FULLER-ROBERTS CLINIC, INC

Practice address

2212 Wilborn Ave
South Boston, VA 24592-1630

Phone

(434) 572-8921

Fax

(434) 572-2063

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Christy Newton II

Title

Office Manager

Phone

(434) 572-8921

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Y King, MD

  • Pediatrics Physician
  • South Boston, VA
  • NPI 1639147739
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1407891815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921630",
            "telephone_number": "434-572-8921",
            "fax_number": "434-572-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921630",
            "telephone_number": "434-572-8921",
            "fax_number": "434-572-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER-ROBERTS CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "434-572-8921",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407891815",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Foot & Ankle Clinic of South Boston PC
• Adriana E. Foster, MD
• Jenilee Rose Foster, P.A.
• Tiffany Francisco, PHARMD
• Fuller Roberts OB-GYN and Primary Care
• William Allen Fuller Jr., MD
• Devmith Chinthaka Gajadeera, M.D.
• Galax Treatment Center, LLC
• Brooke Gasperini, LPC
• Joseph Hugh Gasperini, LPC

• Obstetrics & Gynecology Physician in South Boston, VA
• Providers in South Boston, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.