Earl W Fuller Jr., MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

0101019245 Issued in VA

Practice address

102 Fairview Dr
Suite E
Franklin, VA 23851-1226

Phone

(757) 562-0383

Fax

(757) 962-1254

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cardiology Consultants, LTD

  • Cardiovascular Disease Physician
  • Virginia Beach, VA
  • NPI 1821024597
  NPD (past)
• St Vincents Electrocardiography, Inc

  • Specialist
  • Jacksonville, FL
  • NPI 1902964000
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1962441444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BUSINESS PARK DRIVE",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626335",
            "telephone_number": "757-962-1083",
            "fax_number": "757-962-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FAIRVIEW DR",
            "address_2": "SUITE E",
            "city": "FRANKLIN",
            "state": "VA",
            "postal_code": "238511226",
            "telephone_number": "757-562-0383",
            "fax_number": "757-962-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "EARL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101019245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005848067",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH PLAN",
            "identifier": "33684",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS AND HKP",
            "identifier": "433816",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89063U1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "398492",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Franklin Hospital Corporation
• Franklin Hospital Corporation
• Franklin Rehabilitation and Sports Therapy Inc
• Dale L. Freier, MD
• FTS Outpatient LLC
• Susan Gansor
• Ping Gao, PA-C
• Katie P Garnett, COTA/L
• Alexandria Garris, MSOTR/L
• Katrina Alese Garrou, COTA/L

• Cardiovascular Disease Physician in Franklin, VA
• Providers in Franklin, VA by specialty
• Cardiovascular Disease Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.