Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Faith Fuller

Individual provider Physician Assistant · NPI 1295293611

Carly Faith Fuller is a Physician Assistant in Woodbridge, Virginia. Qualified in 2020, 6 years ago. Practices with Mcv Associated Physicians, a 1,767-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
6
Licensed in
VA
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone: (703) 915-5550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 0110007223 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 0110007223 (VA)

Record details

NPI number1295293611
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 5, 2019
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice McV Associated Physicians — 1767 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Woodbridge