Bradley Kenneth Fullbright, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601 Issued in TN

Practice address

908 W 4TH North St
Morristown, TN 37814-3894

Phone

(423) 492-6100

NPI assigned

May 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, TN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thompson Oncology GroupGroup PAC ID 0941246771, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fullbright.bradley.kenneth@covenanthealth.cernerdirect.com

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.

• Thompson Oncology Group

  • Hematology & Oncology Physician
  • Knoxville, TN
  • NPI 1619975737
  Medicare reassignment Care Compare group
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Physician Assistant

  Medicare reassignment NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD

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

• Morristown Hamblen Hospital Association

  • General Acute Care Hospital
  • Morristown, TN
  • NPI 1912997024
  Care Compare affiliation

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1508488909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143894",
            "telephone_number": "423-492-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143894",
            "telephone_number": "423-492-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032316",
            "country_code": "US",
            "telephone_number": "423-747-8457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLBRIGHT",
        "first_name": "BRADLEY",
        "middle_name": "KENNETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q086381",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fullbright.bradley.kenneth@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "908 W 4th North St",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378143894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nathan McNeil French, M.S., CCC-SLP
• Fresenius Medical Care Morristown, LLC
• Catherine Jennifer Frier, DPT
• Charles Samuel Fulk
• Mistie Dawn Fulk
• George Hugh Fulmer
• Tiffany Fulton
• Terry Curtis Fultz, DO
• Jonas Funderburk, DDS
• Oydun Ardalen Furches

• Physician Assistant in Morristown, TN
• Providers in Morristown, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.