Active NPI
Adam D Fuller, DC
- Chiropractor
- Brighton, MA
National Provider Identifier
1417545310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3010
- Practice address
- 22 Margo Rd
Brighton, MA 02135-3025 - Phone
- (774) 275-4190
- NPI assigned
- Jan 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3010 | MA | Primary |
Addresses
Primary practice location
22 Margo Rd
Brighton, MA 02135-3025
Mailing address
22 Margo Rd
Brighton, MA 02135-3025
Phone (774) 275-4190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3010 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1417545310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MARGO RD",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353025",
"telephone_number": "774-275-4190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 MARGO RD",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353025",
"telephone_number": "774-275-4190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "ADAM",
"middle_name": "D",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-06",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "3010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.