JONATHAN FULLER PA
NPI 1801229745
Physician Assistant - Medical in Thomasville, GA

Q: What is Jonathan Fuller's NPI number?

The NPI number for Jonathan Fuller is 1801229745. It was assigned to this individual provider in the NPPES registry on August 14, 2013.

Q: What is Jonathan Fuller's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Fuller was last updated on June 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 August 14, 2013PECOS Enrolled

915 GORDON AVE, RM 206208, THOMASVILLE, GA 31792(229) 228-2799 Get Directions Write a Review

NPPES record last updated: June 13, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jonathan Fuller Pa NPPES

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

JONATHAN FULLER PA (NPI 1801229745) is an individual medical provider in Thomasville, Georgia and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801229745

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJONATHAN FULLERCredential: PA

Location Address915 GORDON AVE, RM 206208Thomasville, GA 31792-6614

Mailing Address3560 W Pinetree BlvdThomasville, GA 31792-8822 · (850) 445-0918

Phone(229) 228-2799

Sole ProprietorYes

Enumeration DateAugust 14, 2013

Last NPPES UpdateJune 13, 2019

✔ NPI 1801229745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Also ListedPhysician AssistantTaxonomy 363A00000X

915 GORDON AVE, Thomasville, GA 31792

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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)

Jonathan Fuller Pa 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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers62 claims62 services$20.53 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers68 claims68 services$113.72 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MADISON GRACE MAXWELL NP

Nurse Practitioner (Family)