Jessica P Fuller, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110010726 Issued in VA

Practice address

12216 W Broad St Ste 4B-5
Henrico, VA 23233-1062

Phone

(804) 440-4878

Fax

(804) 200-7124

NPI assigned

Jan 16, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Physician Assistant

Practice roles

Locations

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1629722129
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1942011267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715868",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191715868",
            "telephone_number": "804-915-1910",
            "fax_number": "804-968-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12216 W BROAD ST STE 4B-5",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331062",
            "telephone_number": "804-440-4878",
            "fax_number": "804-200-7124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Bremo Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261907",
            "country_code": "US",
            "telephone_number": "804-285-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JESSICA",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Andrew Freeman, DMD
• Cynthia Frey, NP
• Donald Friend
• Kimberly Friend
• Bernard Fuemmeler, PHD, MPH
• Alice Rocha Funez
• Maddison Layne Furman, DR.
• Futures Treasures LLC
• G B Thornton & Associates, LLC
• Omar Gabr, DDS, MS

• Physician Assistant in Henrico, VA
• Providers in Henrico, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.