Kenneth Dwayne Fulks, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MD019595 Issued in TN

Practice address

1601 Hatcher LN
Columbia, TN 38401-4826

Phone

(931) 381-2802

Fax

(931) 388-0719

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Plastic and Reconstructive Surgery

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maury Regional Medical Group, IncGroup PAC ID 7911810742, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maury Regional Hospital Hospital, Columbia, TN, CCN 440073

Merit-based Incentive Payment System (MIPS)

Final score

69.45 of 100Reported as group

Quality

42.88

Promoting interoperability

77

Improvement activities

40

Cost

74.45

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maury Regional Medical Group, Inc

  • Family Medicine Physician
  • Columbia, TN
  • NPI 1205886264
  Medicare reassignment Care Compare group NPD
• Maury Regional Hospital Marshall Medical Center

  • Rural Health Clinic/Center
  • Spring Hill, TN
  • NPI 1548889850
  NPD
• Family Health Group Inc

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1487604799
  NPD (past)

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

• Maury Regional Hospital

  • Clinic/Center
  • Hohenwald, TN
  • NPI 1023038122

  Hospital

  Care Compare affiliation
• Maury Regional Hospital

  • General Acute Care Hospital
  • Columbia, TN
  • NPI 1861479545
  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144237751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014826",
            "telephone_number": "931-381-2802",
            "fax_number": "931-388-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014826",
            "telephone_number": "931-381-2802",
            "fax_number": "931-388-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKS",
        "first_name": "KENNETH",
        "middle_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "MD019595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3059467",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon L Freels, M.D.
• Austin Freeman, PHARMD
• Richard D Fremont, MD
• Fresenius Medical Care Columbia Franklin, LLC
• Michael Allen Fulbright
• Joyce Nadine Fuller
• Megan Imboden Galaske, M.D.
• Chelsea Ashton Galloway, PTA
• Destiny Lynan Gammon
• Sarath Gangavarapu, MD

• Plastic and Reconstructive Surgery Physician in Columbia, TN
• Providers in Columbia, TN by specialty
• Plastic and Reconstructive Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.