Jessica Swink Fulk, PA-C
Individual provider Active NPI Physician Assistant · Denver, NC
NPI 1467946277 · NPPES record last updated Jun 14, 2023
Key facts
- NPI
- 1467946277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-08139 (NC)
- Practice address
- 268 Gillman Rd Ste a
Denver, NC 28037-7925 - Phone
- (704) 659-7830
- Fax
- (877) 881-8455
- NPI assigned
- Jun 15, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180725002875 | NC | Practitioner - Physician Assistant | 2961759675 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-08139 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opportunities Industrialization Center, Inc | Current |
Accepting new patients | |
| Opportunities Industrialization Center, Inc. | Current |
Accepting new patients |
Locations
90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350
Interoperability endpoints
- jfulk986281@direct.unc.nchie.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-08139 | NC | Yes |
Addresses
Primary practice location
268 Gillman Rd Ste a
Denver, NC 28037-7925
Mailing address
9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone (704) 947-5005
Other practice location 1
9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone (704) 947-5005
Other names
- Jessica Leanne Swink
Other providers in Denver, NC
- Maria Fowler
- Emily Megan Fox
- Frank Avason III, DMD, Ms, PA
- Shana Melinda Freeman
- Patricia Marie Froneberger
- Lisa Franck Gardner
- Andrea E Garmon
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
All providers in Denver, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.