Jason Keith Fultz, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2019022592 Issued in MO

Practice address

1650 Slaughter Rd Ste a
Madison, AL 35758-8610

Phone

(256) 325-3646

Fax

(256) 325-3647

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HH Health System Crestwood Physicians, LLCGroup PAC ID 8628546397, 33 clinicians

Crestwood Physician Services, LLCGroup PAC ID 3476735648, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Moulton, AL, CCN 017071
• Amedisys Home Health of Huntsville Home health agency, Huntsville, AL, CCN 017039
• Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131
• Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
• Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

Merit-based Incentive Payment System (MIPS)

Final score

95.45 of 100Reported as apm

Quality

90.9

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.fultz.1@3038.direct.athenahealth.com
• Direct secure messaging: jason.fultz.2@3038.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/3038/brand/1/csg/64/fhir/r4

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.

• Crestwood Physician Services, LLC

  • Family Medicine Physician
  • Huntsville, AL
  • NPI 1154622520
  Medicare reassignment Care Compare group NPD
• HH Health System Crestwood Physicians, LLC

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1487507117
  Medicare reassignment Care Compare group
• Rainbow Family Medicine

  • Clinic/Center
  • Madison, AL
  • NPI 1447498449
  NPD (past)

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

• Amedisys Home Health of Alabama, LLC

  • Home Health Agency
  • Huntsville, AL
  • NPI 1013975309
  Care Compare affiliation
• Crestwood Healthcare LP

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1023061496
  Care Compare affiliation
• HH Health System - Athens Limestone, LLC

  • General Acute Care Hospital
  • Athens, AL
  • NPI 1144695081
  Care Compare affiliation
• Mid-South Home Health, LLC

  • Home Health Agency
  • Moulton, AL
  • NPI 1376572081
  Care Compare affiliation
• The Health Care Authority of the City of Huntsville

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1447221056
  Care Compare affiliation

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1164083093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 E SOUTHAMPTON DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014236",
            "telephone_number": "573-884-7733",
            "fax_number": "573-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SLAUGHTER RD STE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588610",
            "telephone_number": "256-325-3646",
            "fax_number": "256-325-3647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 E Southampton Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652014236",
            "country_code": "US",
            "telephone_number": "573-884-7733",
            "fax_number": "573-882-6228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "JASON",
        "middle_name": "KEITH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019022592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.fultz.1@3038.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1650 Slaughter Rd Ste A",
            "city": "Madison",
            "state": "AL",
            "country_code": "US",
            "postal_code": "357588610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fresenius Medical Care West Madison, LLC
• Herbert C Frith II, M.D.
• Frontier Medical Services
• Sheila P. Fuller, M.C.D.,CCC-SLP
• Taylor D Fuller
• Susan Furtwengler, CRNP
• Gaines Psychological Services, LLC
• Joanne Gallaher, RN
• Hannah Elizabeth Gallant, CRNA
• Meredith Moss Gallaway

• Family Medicine Physician in Madison, AL
• Providers in Madison, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.