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

Emily N Fuller, PA-C

Individual provider Physician Assistant · NPI 1194354506

Emily N Fuller, PA-C is a Physician Assistant in Kettering, Ohio. Qualified in 2020, 6 years ago. Practices with Cotton-O'Neil Clinic Revocable Trust, a 658-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Kansas and Kentucky.

Years since qualifying
6
Licensed in
KS, KY
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3533 Southern Blvd Ste 5650
Kettering, OH 45429-1263
Phone: (937) 294-3611
Fax: (937) 294-9010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1500 Sw 10th Ave, Topeka, KS 66604-1301 — (785) 354-6000
  • 425 W Grand Ave Ste 2002, Dayton, OH 45405-4722 — (379) 294-3611

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15-02470 (KS)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (KY)

Record details

NPI number1194354506
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 7, 2020
Last updated in NPPESJuly 7, 2026
Certification dateJuly 7, 2026

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 Cotton-O'Neil Clinic Revocable Trust — 658 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations12 on file with Medicare

Other providers in Kettering