Jade Fulkerson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12474193 Issued in KY

Practice address

537 Deltona Blvd
Deltona, FL 32725-8017

Phone

(904) 878-8683

NPI assigned

Jul 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Behavioral Foundation Centers Inc

  • Behavior Analyst
  • Deltona, FL
  • NPI 1689170409
  NPD
• Exceptional Learning Institute, Inc

  • Behavior Analyst
  • Deltona, FL
  • NPI 1831979012
  NPD

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1508604067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 DELTONA BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327258017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 DELTONA BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327258017",
            "telephone_number": "904-878-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "JADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "12474193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Mae Freeman
• Howard Freiman, RPH
• Alexandra Fry, MD
• Adays Fuentes Chacon
• Paul D Fuldauer, RD
• Function Health and Wellness
• Lejanise Fuster
• Christina Ann Gagliardy, COTA/L
• Kaleah Shantil Gaines
• Carol Gambeski, RPH

• Behavior Analyst in Deltona, FL
• Providers in Deltona, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.