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

Larry Chad Fuller, STUDENT

Individual provider Diagnostic Radiology Physician · NPI 1912360421

Larry Chad Fuller, STUDENT is a Diagnostic Radiology in Gainesville, Florida. Qualified in 2016, 10 years ago. Practices with St Francis Physician Practices LLC, a 210-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Florida, Georgia and Virginia.

Years since qualifying
10
Licensed in
FL, GA, VA
In the registry since
2016
Specialties on file
4
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1600 SW Archer Rd
Gainesville, FL 32610-2360
Phone: (352) 265-0291
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 743 Spring St Ne, Gainesville, GA 30501-3715 — (770) 271-9000
  • 500 University Dr, Hershey, PA 17033-2360 — (800) 243-1455
  • 2300 Opitz Blvd, Woodbridge, VA 22191-3311 — (703) 523-1199

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence OS17722 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0102209072 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 1322733 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1912360421
Entity typeIndividual (Type 1)
GenderMale
Credentials STUDENT
Sole proprietorNo
NPI enumeratedApril 1, 2016
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025
Mailing addressPo Box 100374, Gainesville, FL 32610-0374

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St Francis Physician Practices Llc — 210 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations24 on file with Medicare

Other providers in Gainesville