Daniel Boston Fuller

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

0024171194 Issued in VA

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone

(828) 230-4102

NPI assigned

Sep 14, 2013

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dfuller1151257@direct.bsmhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1629637475
  Medicare reassignment NPD
• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Franklin, VA
  • NPI 1205451028
  NPD

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

{
    "created_epoch": "1379116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1629404264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "828-230-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "828-230-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DANIEL",
        "middle_name": "BOSTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-14",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "VA",
            "license": "0024171194",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024171194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Friendly Faces Pediatric Dentistry
• Friends of Faith LLC
• Candice Nickens Frye, PHARMD
• Marcia Lynne Frye, MD
• Daniel Jacob Fuhrmann, DMD
• Kayla Fuller, PA-C
• Khadijah Fuller, CNM
• Meateran A Funwi, DNP
• Mariama A Furman, DO
• George Hanson Futch Jr., PHARMD

• Acute Care Nurse Practitioner in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Acute Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.