DANIEL BOSTON FULLER
NPI 1629404264
Nurse Practitioner - Acute Care in Portsmouth, VA

Q: What is Daniel Fuller's NPI number?

The NPI number for Daniel Fuller is 1629404264. It was assigned to this individual provider in the NPPES registry on September 14, 2013.

Q: What is Daniel Fuller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Fuller was last updated on February 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 September 14, 2013PECOS Enrolled

620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(828) 230-4102 Get Directions Write a Review

NPPES record last updated: February 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Daniel Boston Fuller NPPES

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

DANIEL BOSTON FULLER (NPI 1629404264) is an individual acute care provider in Portsmouth, Virginia, licensed in Virginia (0024171194) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629404264

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NameDANIEL BOSTON FULLER

Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111

Mailing Address620 John Paul Jones CirPortsmouth, VA 23708-2111 · (828) 230-4102

Phone(828) 230-4102

Sole ProprietorNo

Enumeration DateSeptember 14, 2013

Last NPPES UpdateFebruary 2, 2022

NPPES CertifiedFebruary 2, 2022

✔ NPI 1629404264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in VA · 0024171194

Also ListedClinical Nurse Specialist · Acute CareTaxonomy 364SA2100X · License 0024171194 (VA)

620 JOHN PAUL JONES CIR, Portsmouth, VA 23708

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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)

Daniel Boston 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 23708 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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.

MEREDITH TVERDOSI CRNA

Nurse Anesthetist, Certified Registered

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-3238

ERIC FRANCIS SULAVA

Emergency Medicine

620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

MRS. TIFFNY KUPER RHH

Dental Hygienist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2711

DR. LAKEISHA GOODE PHARMD

Pharmacist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-7462

JASMINE WOOD MD

Surgery

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-1895

NICHOLAS FANSELOW

General Practice

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

DR. DAVID JESSEN MD

Military Health Care Provider

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2518

MRS. WILLAR MAE BAUM L.C.S.W.

Social Worker (Clinical)

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-9767

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Daniel Fuller's NPI number?

The NPI number for Daniel Fuller is 1629404264. It was assigned to this individual provider in the NPPES registry on September 14, 2013.

Where is Daniel Fuller located?

Daniel Fuller practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (828) 230-4102.

What is Daniel Fuller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Daniel Fuller enrolled in Medicare?

Yes. Daniel Fuller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Daniel Fuller was last updated on February 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.