Randy Curtis Fullerton, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16963 Issued in TN

Practice address

2021 Church St
Suite 504
Nashville, TN 37203-2021

Phone

(615) 284-7900

Fax

(615) 284-3488

NPI assigned

Dec 3, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• Fullerton Medical Clinic, PLLC

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1164567830
  NPD Authorized official

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

{
    "created_epoch": "1133568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356325237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9235 COXBORO CT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277435",
            "telephone_number": "615-661-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CHURCH ST",
            "address_2": "SUITE 504",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032021",
            "telephone_number": "615-284-7900",
            "fax_number": "615-284-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "RANDY",
        "middle_name": "CURTIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "16963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105694",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ma'Rion Fuller, DMD
• Matthew Gerald Fuller
• Torri Fuller, PHARMD
• Fullerton Medical Clinic, PLLC
• Fullerton Medical Group
• Fullfillment Tender Care, Inc.
• Jacqueline Fullwood
• Briana A Fulton
• Michelle Fulton
• Shannon Renee Fulton, CRNA

• Internal Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Internal Medicine 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.