Courtney Lynn Fullmer, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71011620A Issued in IN

Practice address

1130 N J St
Richmond, IN 47374-1913

Phone

(659) 833-2987

NPI assigned

Apr 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cskaggs298674@reidhealth.direct-ci.com

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.

• Reid Physician Associates, Inc.

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment Care Compare group NPD
• Reid Physician Associates, Inc

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD

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

• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1114508058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-935-8802",
            "fax_number": "765-983-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N J ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741913",
            "telephone_number": "659-833-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28176654A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71011620A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cskaggs298674@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fresh Fruits
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• Emma Fugate
• Mason Fulton
• Abby Lynn Fultz
• James Furnari
• Elizabeth Marie Gabbard, LCSW
• Gabor L Tolnay MD PC

• Psychiatric/Mental Health Nurse Practitioner in Richmond, IN
• Providers in Richmond, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.