Active NPI
Corene S Fuller, PA
- Physician Assistant
- Charlottesville, VA
National Provider Identifier
1912851627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110012074
- Practice address
- 1215 Lee St
Charlottesville, VA 22908-0816 - Phone
- (434) 924-2547
- Fax
- (434) 982-1893
- NPI assigned
- Feb 21, 2026
- Last updated
- Sep 9, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110012074 | VA | Primary |
Addresses
Primary practice location
1215 Lee St
Charlottesville, VA 22908-0816
Mailing address
PO Box 749112
Atlanta, GA 30374-9112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Atlanta, GA 30374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1912851627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 749112",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303749112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 LEE ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229080816",
"telephone_number": "434-924-2547",
"fax_number": "434-982-1893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "CORENE",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-21",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110012074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.