JON D FULLER (NPI# 1225080765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225080765 |
| Entity Type | Individual |
| Full Name | JON D FULLER |
| Credential | MD |
| Practice Address |
7 Shackleford West Blvd Little Rock AR 72211-3886 |
| Practice Telephone | 5016645860 |
| Practice Fax Number | 5016640889 |
| Mailing Telephone | 5016645860 |
| Mailing Fax Number | 5016640889 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | E4323 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 158312001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376566976 | Jon Gordon Fuller Jr. | Dentist | 570 W 400 N, Moab, UT 84532-2236 | 2006-07-25 |
| 1245270412 | Jon D Fuller | Internal Medicine | 3801 Miranda Ave., Va Palo Alto Hcs, Palo Alto, CA 94304 | 2006-06-07 |
| 1952387946 | Jon D. Fuller | Family Medicine | 725 Albany Street, Shapiro 9, Suite B, Boston, MA 02118-2526 | 2005-12-21 |
| Street Address |
7 SHACKLEFORD WEST BLVD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-3886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861485302 | Scott L Beau | Internal Medicine | 7 Shackleford West Blvd, Little Rock, AR 72211 | 2005-08-30 |
| 1801411285 | Allyson D Carroll | Dietitian, Registered | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2020-06-11 |
| 1104476720 | Abigail Grace Connerly | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-09-16 |
| 1013560655 | Angela Denise Cheves | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-07-23 |
| 1922565233 | Crystal E Meziere | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-02-22 |
| 1134685217 | Felicia Mae Johnson | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2019-02-14 |
| 1588132948 | Lauren Elizabeth Mcbride | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-11-05 |
| 1144705047 | Cassandra Love | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-09-27 |
| 1457832842 | Marissa Boggs | Nurse Practitioner | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-08-24 |
| 1568955441 | Jared H Umland | Physician Assistant | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004618 | Samantha Lenore Hilborn | Behavior Technician | 1525 Merrill Drive Suite 100, Little Rock, AR 72211 | 2020-05-14 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1962040568 | Erica N Taylor | Nurse Practitioner | 11800 Financial Center Parkway, Ste 290, Little Rock, AR 72211 | 2019-12-13 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1699283838 | Kara Elizabeth Simmons | Physician Assistant | 11215 Hermitage Rd Ste 103, Little Rock, AR 72211 | 2018-01-22 |
| 1194241463 | Wendy Newsam Pllc | Counselor | 1 Innwood Circle, Suite 107, Little Rock, AR 72211 | 2017-08-18 |
| 1861915159 | Sarah Renee Beall | Counselor | 10800 Financial Centre #290, Little Rock, AR 72211 | 2017-07-19 |
| 1457873127 | Restore Hope Counseling Center, Pllc | Counselor | One Innwood Circle, Suite 201, Little Rock, AR 72211 | 2017-07-13 |
| 1447707500 | University of Arkansas for Medical Sciences | Durable Medical Equipment & Medical Supplies | 601 Autumn Road, Little Rock, AR 72211 | 2016-09-07 |
| Find all providers in zip 72211 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295154789 | Nolan R Bruce | Surgery | 4301 W Markham St # 520-1, Little Rock, AR 72205-7101 | 2014-04-10 |
| 1366888711 | Raj Patel | Surgery | 4100 Outpatient Cirlce, 616, Little Rock, AR 72205 | 2013-05-13 |
| 1386987766 | Rebecca Empting Bittenbinder | Surgery | 400 Jack Stephens Dr Fl 2, Little Rock, AR 72205 | 2013-04-03 |
| 1275859076 | Kyla Rae Shelton | Surgery | 4301 W Markham St # 520-2, Little Rock, AR 72205-7101 | 2010-04-19 |
| 1972837615 | John W. Baker, Md, Pa | Surgery | 1 Lile Ct Ste 103, Little Rock, AR 72205-6239 | 2009-09-29 |
| 1104076439 | Lawrence Edward Greiten | Surgery | 1 Childrens Way # 200, Little Rock, AR 72202 | 2008-09-23 |
| 1063671949 | Patrick Pakkee Szeto | Surgery | 701 N University Ave Ste 203, Little Rock, AR 72205-2936 | 2008-06-05 |
| 1700057098 | Emilio Tirado, M.d. Pa | Surgery | 500 N University Ave, Ste 808, Little Rock, AR 72205 | 2008-03-14 |
| 1508058462 | William Dale Morris Jr. | Surgery | 12924 Crystal Valley Rd, Little Rock, AR 72210-4715 | 2007-08-15 |
| 1720289945 | Anna Nicole Rinewalt | Surgery | 1 Childrens Way # 210, Little Rock, AR 72202-3500 | 2007-05-29 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.