Individual provider Active NPI

Brenteney Fortune, FNP-C, CRNP

  • Family Nurse Practitioner
  • Fulton, MS
National Provider Identifier
1275357121
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
908070 Issued in MS
Practice address
101 Houston Lake Rd
Fulton, MS 38843-8992
Phone
(662) 891-1889
NPI assigned
Nov 7, 2024
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

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

LicenseStateTypeSpecialty
3-002837ALMDFamily Nurse Practitioner
908070MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Medical Clinic PC Family CurrentSince May 2, 2026 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.

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

Verify at the official NPI Registry.