Jennifer Lee Fuller, APRN-CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

204314 Issued in OK

Practice address

1302 S Lynn LN
Idabel, OK 74745-6860

Phone

(580) 286-3993

NPI assigned

Jul 19, 2021

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lee Rodgers Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Group practices

Walkup Family Medicine Clinic LLCGroup PAC ID 6507279171, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health of Southeast Oklahoma Home health agency, Hugo, OK, CCN 377633
• Mays Housecall Home Health of South East Ok, LLC Home health agency, Idabel, OK, CCN 377169
• Rainbow Home Health, Inc Home health agency, Antlers, OK, CCN 377630
• McCurtain Memorial Hospital Hospital, Idabel, OK, CCN 371342

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JFHDCD
• FHIR API: https://fhir4.healow.com/fhir/r4/JFHDCD/Endpoint/JFHDCD

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

• Walkup Family Medicine Clinic LLC

  • Primary Care Clinic/Center
  • Idabel, OK
  • NPI 1508461856
  Medicare reassignment Care Compare group NPD

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

• Healthcare Innovations of Oklahoma LLC

  dba Enhabit Home Health of Southeast Oklahoma

  • Home Health Agency
  • Hugo, OK
  • NPI 1588644843
  Care Compare affiliation
• Mays Housecall Home Health of South East Ok, LLC

  dba Mays Home Care Broken Bow

  • Home Health Agency
  • Idabel, OK
  • NPI 1275023756
  Care Compare affiliation
• McCurtain Memorial Medical Management, Inc.

  dba McCurtain Memorial Hospital

  • Critical Access Hospital
  • Idabel, OK
  • NPI 1063900975
  Care Compare affiliation
• Rainbow Home Health, Inc

  • Home Health Agency
  • Antlers, OK
  • NPI 1831242916
  Care Compare affiliation

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1245803345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 S LYNN LN",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456860",
            "telephone_number": "580-286-3993",
            "fax_number": "580-286-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S LYNN LN",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456860",
            "telephone_number": "580-286-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "204314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RODGERS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Idabel, OK
• Providers in Idabel, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.