Individual provider Active NPI

Andrea M Fulena, MT

  • Physical Medicine & Rehabilitation Physician
  • Fredericksburg, VA
National Provider Identifier
1972808939
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0019007537 Issued in VA
Practice address
6330 Five Mile Centre Park
Suite 406
Fredericksburg, VA 22407
Phone
(540) 785-9770
Fax
(540) 785-9772
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0019007537 VA Primary

Addresses

Primary practice location

6330 Five Mile Centre Park
Suite 406
Fredericksburg, VA 22407

Mailing address

6119 New Pembrook LN
Fredericksburg, VA 22407-8378
Phone (540) 220-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
0019007537VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Hospital Inc. Past Accepting new patients
Premier Physical Therapy PastSince Mar 5, 2008 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1972808939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 NEW PEMBROOK LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224078378",
            "telephone_number": "540-220-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 FIVE MILE CENTRE PARK",
            "address_2": "SUITE 406",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-785-9770",
            "fax_number": "540-785-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULENA",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0019007537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.