Individual provider Active NPI

Jennifer Carroll Fulton, MD

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1083783609
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME104269 Issued in FL
Practice address
1325 San Marco Blvd Ste 300
Jacksonville, FL 32207-8567
Phone
(904) 253-6910
Fax
(904) 253-6964
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME104269 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME104269 FL
Pulmonary Disease Physician 207RP1001X ME 104269 FL
Pulmonary Disease Physician 207RP1001X ME104269 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd Ste 300
Jacksonville, FL 32207-8567

Mailing address

1325 San Marco Blvd Ste 300
Jacksonville, FL 32207-8567
Phone (904) 253-6910

Other identifiers 1

IdentifierTypeStateIssuer
004352900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100423000257 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0840208195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Rochester School of Medicine and Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1325 San Marco Blvd
Jacksonville, FL 32207-8568
Phone (904) 253-6910

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Merit-based Incentive Payment System (MIPS)

Final score
91.86 of 100Reported as group
Quality
85.7
Promoting interoperability
100
Improvement activities
40
Cost
78.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 104269FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Critical Care and Sleep Medicine Associates,Inc Pulmonary Disease CurrentSince Mar 11, 2010 Accepting new patients
Baptist MD Anderson Cancer Physicians Inc Internal Medicine PastSince Apr 16, 2023 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

1443 San Marco Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 253-6910

1325 San Marco Blvd
Ste 300
Jacksonville, FL 32207
Phone (904) 202-4243

1325 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 253-6910

Interoperability endpoints

  • Direct secure messaging: jenniferfulton@rccsma.allscriptsdirect.net

Organizations & group practices 3

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1083783609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078567",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078567",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "JENNIFER",
        "middle_name": "CARROLL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME104269",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME104269",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME 104269",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME104269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004352900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.