ROBERT MONTGOMERY FULLER
NPI 1467255380
Pediatrics in Jackson, MS

Q: What is Robert Fuller's NPI number?

The NPI number for Robert Fuller is 1467255380. It was assigned to this individual provider in the NPPES registry on March 27, 2025.

Q: What is Robert Fuller's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Fuller was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 27, 2025PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 948-1000 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 1, 2025, Mar 28, 2025 (2 updates tracked since 2025).

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About Robert Montgomery Fuller NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT MONTGOMERY FULLER (NPI 1467255380) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (T-5609) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467255380

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameROBERT MONTGOMERY FULLER

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address2500 N State StJackson, MS 39216-4500

Phone(601) 948-1000

Sole ProprietorNo

Enumeration DateMarch 27, 2025

Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration

NPPES CertifiedJuly 1, 2025

✔ NPI 1467255380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MS · T-5609

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2500 N STATE ST, Jackson, MS 39216

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Montgomery Fuller is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)