Active NPI
Jaynee Lee Fuller, ARNP
- Nurse Practitioner
- Blairsville, GA
National Provider Identifier
1700869773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN227177
- Practice address
- 35 Hospital Rd
Blairsville, GA 30512-3139 - Phone
- (706) 747-1036
- Fax
- (706) 747-1046
- NPI assigned
- Nov 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9228873 | FL | |
| Nurse Practitioner | 363L00000X | RN227177 | GA | Primary |
Addresses
Primary practice location
35 Hospital Rd
Blairsville, GA 30512-3139
Mailing address
33920 US Highway 19 N
Suite 214
Palm Harbor, FL 34684-2654
Phone (727) 779-9793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30010894 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9228873 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wendy L Smith M.D. PC | Past | Accepting new patients | |
| Chatuge Regional Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Hiawassee, GA
- NPI 1265811962
-
- Otolaryngology Physician
- Blairsville, GA
- NPI 1184880338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1700869773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33920 US HIGHWAY 19 N",
"address_2": "SUITE 214",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346842654",
"telephone_number": "727-779-9793",
"fax_number": "727-773-0674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 HOSPITAL RD",
"city": "BLAIRSVILLE",
"state": "GA",
"postal_code": "305123139",
"telephone_number": "706-747-1036",
"fax_number": "706-747-1046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "JAYNEE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-23",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "9228873",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN227177",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30010894",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Blairsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.