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Robert Montgomery Fuller

Pediatrics β€’ Jackson, MS

Active NPI 1467255380 Individual Practitioner Male Practitioner
Practice location in NPPES

2500 N State St
Jackson, MS 392164500

Call 6019481000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2500 N State St

Jackson, MS 392164500

Telephone 6019481000
Organization at the Same NPPES Address or Phone

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Robert Fuller has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Robert Fuller as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Jackson and Mississippi

130 active clinicians are listed under Pediatrics with a practice address in Jackson, MS (418 in Mississippi).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jackson

0% of these 130 clinicians have the CMS telehealth indicator.

11.5% of these 130 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-07-01
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES MS T-5609

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Mississippi State Medical Licensing Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20250911002066

Enrollment State Jurisdiction

MS

PECOS Control ID

7416450937

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
Dr. Noah Abbas , MD

Emergency Medicine

NPI 1982991246

Doctor of Medicine (M.D.)

Dr. Syed Abbas , MD

Pathology - Anatomic Pathology & Clinical Pathology

NPI 1407378961

Doctor of Medicine (M.D.)

Dr. George Abraham , MD

Internal Medicine - Pulmonary Disease

NPI 1518052257

Doctor of Medicine (M.D.)

Mackenzie Acosta , CRNA

Nurse Anesthetist, Certified Registered

NPI 1699472928

Certified Registered Nurse Anesthetist

Dr. Dominic Adams , MD

Psychiatry & Neurology - Psychiatry

NPI 1326625310

Doctor of Medicine (M.D.)

Dorothy Adcock

Nurse Practitioner - Family

NPI 1851841548

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2025

Pediatrics (license number reported to NPPES: MS T-5609)

βœ…
NPI Profile Active March 28, 2025

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 28, 2025

Registered at 2500 N STATE ST, JACKSON, MS 392164500 (Tel: 6019481000)

πŸ“
Business Mailing Address (Initial Record) March 28, 2025

Registered at 2500 N STATE ST, JACKSON, MS 392164500

πŸ‘€
Provider Name / Credentials (Initial Record) March 28, 2025

Recorded as ROBERT FULLER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2025

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration March 27, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1467255380
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2025
Last Update: July 01, 2025
Sole Proprietor: No

Other Pediatrics Specialists in Jackson

All Pediatrics Specialists in Jackson

Mailing Address

2500 N State St

Jackson, MS 392164500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.