Chrystal Tarryn Fullen, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

19-32AP-PL Issued in AR

Practice address

4301 W Markham St # 589
Little Rock, AR 72205-7101

Phone

(501) 526-8284

NPI assigned

May 20, 2016

Last updated

Aug 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cfullen734274@direct.baptist-healthar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arkansas Health Group

  dba Rehabilitation Medicine Associates of Arkansas

  • Physical Medicine & Rehabilitation Physician
  • Little Rock, AR
  • NPI 1649365347
  Medicare reassignment Care Compare group NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• Chrystal Fullen Ms LPC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1952800658
  NPD Authorized official
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1871655050
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1053768911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 589",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 589",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLEN",
        "first_name": "CHRYSTAL",
        "middle_name": "TARRYN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "19-32AP-PL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Burrichter Fulford
• Brian Christopher Fulks, CRNA
• Brittany Elizabeth Fulks, APRN
• Full Potential
• Full Potential
• Clinton J Fuller, M.D.
• Katherine Fuller
• Marshal Fuller, MNSC, APRN, AGACNP-B
• Paula Knod Fuller, CRNA
• William S Fuller, LCSW

• Clinical Neuropsychologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Neuropsychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.