Active NPI
Brenteney Fortune, FNP-C, CRNP
- Family Nurse Practitioner
- Fulton, MS
National Provider Identifier
1275357121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 908070
- Practice address
- 101 Houston Lake Rd
Fulton, MS 38843-8992 - Phone
- (662) 891-1889
- NPI assigned
- Nov 7, 2024
- Last updated
- Aug 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3-002837 | AL | |
| Family Nurse Practitioner | 363LF0000X | 908070 | MS | Primary |
Addresses
Primary practice location
101 Houston Lake Rd
Fulton, MS 38843-8992
Mailing address
101 Houston Lake Rd
Fulton, MS 38843-8992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
101 Houston Lake Rd
Fulton, MS 38843-8992
1911 Military St S
Hamilton, AL 35570-6611
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3-002837 | AL | MD | Family Nurse Practitioner |
| 908070 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Medical Clinic PC | Family | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Nurse Practitioner
- Hamilton, AL
- NPI 1174643852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786579200000",
"number": "1275357121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HOUSTON LAKE RD",
"city": "FULTON",
"state": "MS",
"postal_code": "388438992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HOUSTON LAKE RD",
"city": "FULTON",
"state": "MS",
"postal_code": "388438992",
"telephone_number": "662-891-1889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNE",
"first_name": "BRENTENEY",
"credential": "FNP-C, CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-07",
"last_updated": "2026-08-13",
"certification_date": "2026-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "3-002837",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "908070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fulton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.