Robert Kirby Fuqua IV

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122593 Issued in MA

Practice address

460 Quincy Ave
Quincy, MA 02169-8130

Phone

(617) 847-1950

Fax

(617) 774-1490

NPI assigned

Aug 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1588912679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 S RUSSELL ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143938",
            "telephone_number": "773-984-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698130",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "ROBERT",
        "middle_name": "KIRBY",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "1490.18332",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Fuentes
• Carina Lynn Fuller, MA
• Kathleen Marie Fuller, NP
• Claire Y Fung, M.D.
• Hak Yung Fung, ACUPUNCTURIST
• David Furlong, B.A.
• Lauren Katie Fusek, FNP
• Pawel Fusiek
• Deborah Gabriel
• Jenny Gabriel

• Clinical Social Worker in Quincy, MA
• Providers in Quincy, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.