REBECCA BALDWIN FULLER (NP) – Adult Health Nurse Practitioner, NPI 1083818389
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,508 NURSE PRACTITIONER in WV
Provider Addresses for REBECCA BALDWIN FULLER (NP)
44035 RIVERSIDE PKWY STE 300
LEESBURG, VA 201768260
Phone: (703) 554-6800
Fax: (703) 724-7503
Type: Mailing
80 MADDEX DR
SHEPHERDSTOWN, WV 254434305
Phone: (304) 876-9422
Type: Location
209, Gibson Street Northwest, Leesburg, Loudoun County, Virginia, 20176, United States
SUITE 202
LEESBURG, VA 201762122
Phone: (646) 228-4868
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110421000148 | I | Nurse Practitioner | VA | TBD |
| I20110525000079 | I | Nurse Practitioner | DC | TBD |
| I20240816002799 | I | Nurse Practitioner | WV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 20176)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WV | |
| Internal Medicine | WV | |
| Nurse Practitioner | WV | |
| Hospitalist, Internal Medicine | WV | |
| - | WV | |
| Nurse Practitioner | WV | |
| - | WV |
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