Britteny Donielle Fultz, APRN
Individual provider Active NPI Primary Care Nurse Practitioner · Harrogate, TN
NPI 1548754880 · NPPES record last updated Jun 20, 2018
Key facts
- NPI
- 1548754880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- APRN24365 (TN)
- Practice address
- 170 Beech St Ste 1
Harrogate, TN 37752-8251 - Phone
- (423) 869-3684
- Fax
- (423) 869-5460
- NPI assigned
- Jun 20, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chuc, LLC
Practice addresses (Care Compare)
117 Gill St
Alcoa, TN 37701-2672
Phone (865) 982-3409
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- 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 |
|---|---|---|---|---|
| I20180829004703 | TN | Practitioner - Nurse Practitioner | 3476803172 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24365 | TN | MD | Family Medicine Physician |
| APRN24365 | TN | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Well-Key Health, PLLC | Current |
Accepting new patients | |
| Chuc, LLC | Current |
Accepting new patients | |
| DX Mso, PLLC | Current |
Accepting new patients | |
| Ut Urgent Care Centers LLC | Current |
Accepting new patients | |
| Chuc, LLC | Past |
Accepting new patients | |
| Abercrombie Radiological Consultants Inc | Past |
Accepting new patients | |
| Chuc, LLC | Past |
Accepting new patients | |
| Chuc, LLC | Past |
Accepting new patients | |
| Summit View Health Services, LLC | Past |
Accepting new patients |
Locations
700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426
117 Gill St
Alcoa, TN 37701
Phone (865) 982-3409
1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990
7625 Chapman Hwy
Ste 107
Knoxville, TN 37920
Phone (863) 983-1310
9625 Kroger Park Dr
Ste 300
Knoxville, TN 37922
Phone (865) 539-2287
5779 Creekwood Park Blvd
Ste 110
Lenoir City, TN 37772
Phone (865) 635-2810
1130 Middle Creek Rd
Ste 270
Sevierville, TN 37862
Phone (865) 365-3074
1787 Veterans Blvd
Ste 101
Sevierville, TN 37862
Phone (865) 428-2773
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | APRN24365 | TN | Yes |
Addresses
Primary practice location
170 Beech St Ste 1
Harrogate, TN 37752-8251
Mailing address
PO Box 750
Harrogate, TN 37752-0750
Phone (423) 869-3684
Other providers in Harrogate, TN
- Family Medical Clinic of Harrogate, P.C.
- Lexi Fleming
- Megan Ford
- Christopher Fraley
- Emilie Francois
- Karoline Gasque
- Jessica Ghebranious
- Julia Megan Gigliotti
- Saraa Girges
- Nancy Deane Good Maddox
All providers in Harrogate, TN · Primary Care Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2018. 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.