Full Potential Senior Solutions

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

15048/11.1 Issued in MS

Legal business name

FULL POTENTIAL SENIOR SOLUTIONS

Practice address

405 Highway 51 S
Batesville, MS 38606-2549

Phone

(662) 563-0670

Fax

(662) 563-7304

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Tamekia Renix Jackson, RN

Title

Ceo

Phone

(662) 563-0670

Specialties & licenses 1

Addresses

Other names 1

• Full Potential Medical Supply Doing business as

Locations

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1083157804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 51 S",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386062549",
            "telephone_number": "662-563-0670",
            "fax_number": "662-563-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 51 S",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386062549",
            "telephone_number": "662-563-0670",
            "fax_number": "662-563-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL POTENTIAL SENIOR SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAMEKIA",
        "authorized_official_middle_name": "RENIX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-563-0670",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "15048/11.1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Full Potential Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Raine Fortner, DMD
• Margaret Fox
• Lillian Frankart, PHD
• Full Potential Adult Daycare, LLC
• Full Potential LLC
• Marcia Rebekah Garrett, FNP
• Lea Andy Garrott, DMD
• Angela Gee, ANGELA MORROW GEE
• Genesis Hospice Care, LLC
• Maegan Gentry

• Durable Medical Equipment & Medical Supplies in Batesville, MS
• Providers in Batesville, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.