Timothy Michael Fullagar, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

41401 Issued in TN

Practice address

701 Med Tech Pkwy
Suite 300
Johnson City, TN 37604-2365

Phone

(423) 232-8301

Fax

(423) 232-8304

NPI assigned

Aug 8, 2006

Last updated

Sep 28, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Ridge Medical Management

  dba MSMG Gen Surg Erwin

  • Surgery Physician
  • Erwin, TN
  • NPI 1811380520
  NPD
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1629088364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "address_2": "SUITE 300",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-232-8301",
            "fax_number": "423-232-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "address_2": "SUITE 300",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042365",
            "telephone_number": "423-232-8301",
            "fax_number": "423-232-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLAGAR",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "41401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Fuentes, CRNA
• Erika Marie Fugere, LCSW
• Jordan Fugitt, PHARMD
• Alana Mary Fuhr, PTA
• Aleksandr M. Fuks, M.D.
• Fuller Rehabilitation and Consulting Services, Inc. (Fuller Rehabilitation)
• Kira Fuller, DO
• Mary Leah Fultineer, BA CPRP
• Functional Feeding Solutions
• Mary Helen Fuqua, CTRS

• Neurological Surgery Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.