FULLER ROBERTS OB-GYN AND PRIMARY CARE
NPI 1366814113
Obstetrics & Gynecology in South Boston, VA

NPI Status: Active since October 20, 2015

Contact Information

2212 WILBORN AVE
SOUTH BOSTON, VA
ZIP 24592
Phone: (434) 572-8921

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  • Organization
  • Obstetrics & Gynecology
  • CLIA Number: 49D2112666
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-28-2026

About FULLER ROBERTS OB-GYN AND PRIMARY CARE

This page provides the complete NPI Profile along with additional information for Fuller Roberts Ob-gyn And Primary Care, a women's health care provider established in South Boston, Virginia operating as a Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1366814113 assigned on October 2015. The practitioner's primary taxonomy code is 207V00000X with license number 0101239403 (VA). The provider is registered as an organization and their NPI record was last updated 11 years ago. Fuller Roberts Ob-gyn And Primary Care operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Duc Trieu M.d. (Owner / M.d.)

NPI
1366814113
Provider Name
FULLER ROBERTS OB-GYN AND PRIMARY CARE
Entity Type
Organization
Location Address
2212 WILBORN AVE SOUTH BOSTON, VA 24592
Location Phone
(434) 572-8921
Mailing Address
2212 WILBORN AVE SOUTH BOSTON, VA 24592
Mailing Phone
(434) 572-8921
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-20-2015
Last Update Date
10-20-2015
Code Navigator

Women's health care providers like Fuller Roberts Ob-gyn And Primary Care treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
0101239403
License State
VA
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DUC TRIEU M.D.

Authorized Official Title
OWNER / M.D.
Authorized Official Phone
(434) 572-8921

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D2112666
Facility Type
Physician Office
Certificate Effective Date
December 29, 2024
Certificate Expiration Date
December 28, 2026
Laboratory Director
DUC TRIEU
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Fuller Roberts Ob-gyn And Primary Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1366814113, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
6
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
1
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 4 → 8 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 2 + 6 + 1 + 6 + 1 + 8 + 1 + 2 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1366814113.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Nurse Practitioner (Pediatrics)
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Nurse Practitioner
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Surgery
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Obstetrics & Gynecology
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Pediatrics
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Obstetrics & Gynecology
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Clinic/Center (Ambulatory Surgical)
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Nurse Practitioner (Family)
2212 WILBORN AVE
SOUTH BOSTON, VA 24592
Obstetrics & Gynecology
2212 WILBORN AVE
SOUTH BOSTON, VA 24592

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366814113, enumerated as an "organization" on October 20, 2015.

The provider is located at 2212 WILBORN AVE SOUTH BOSTON, VA 24592 and the phone number is (434) 572-8921.

Obstetrics & Gynecology with taxonomy code 207V00000X.