Virginia Jean Fulton, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R122264 Issued in MD

Practice address

12254 Rockville Pike
Rockville, MD 20852

Phone

(301) 230-2767

Fax

(301) 230-2780

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Virginia Jean Angert Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Yardmore Emergency Physicians LLC

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1730131657
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1639128739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 ROCKVILLE PIKE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-230-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 ROCKVILLE PIKE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-230-2767",
            "fax_number": "301-230-2780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 State Street",
            "address_purpose": "LOCATION",
            "city": "La Porte",
            "state": "IN",
            "postal_code": "463503115",
            "country_code": "US",
            "telephone_number": "219-324-3431",
            "fax_number": "219-362-3802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Glendale Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463833769",
            "country_code": "US",
            "telephone_number": "219-462-0555",
            "fax_number": "219-548-3681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11717 Old National Pike Ste 8",
            "address_purpose": "LOCATION",
            "city": "New Market",
            "state": "MD",
            "postal_code": "217746119",
            "country_code": "US",
            "telephone_number": "301-882-7489",
            "fax_number": "301-882-7520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTON",
        "first_name": "VIRGINIA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71003108A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381890",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71003108B",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R122264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699367200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "ANGERT",
            "middle_name": "JEAN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Karim Fullah
• Deborah Marlene Fuller, LCSW-C
• Kiesha Fuller
• Linda Jo Fuller, D.O.
• Sha'Ron Fuller
• Alexia Funchess
• Functional Physical Therapy, LLC
• Nyla Funderburk
• Harmony Fungchung
• Nicole Njijen Fuondjing I, NP

• Pediatric Nurse Practitioner in Rockville, MD
• Providers in Rockville, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.