Jacqueline Fullwood

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2000 Glen Echo Rd Ste 101
Nashville, TN 37215-2857

Phone

(615) 457-8585

Fax

(615) 457-8595

NPI assigned

Feb 1, 2022

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Nashville Brain Institute

  • Psychiatry Physician
  • Nashville, TN
  • NPI 1942785159
  NPD

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1649923582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GLEN ECHO RD STE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152857",
            "telephone_number": "615-457-8585",
            "fax_number": "615-457-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GLEN ECHO RD STE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152857",
            "telephone_number": "615-457-8585",
            "fax_number": "615-457-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLWOOD",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Torri Fuller, PHARMD
• Fullerton Medical Clinic, PLLC
• Fullerton Medical Group
• Randy Curtis Fullerton, M.D.
• Fullfillment Tender Care, Inc.
• Briana A Fulton
• Michelle Fulton
• Shannon Renee Fulton, CRNA
• Emma S Fults, MA
• Teresa Fulwood, NP

• Counselor in Nashville, TN
• Providers in Nashville, TN by specialty
• Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.