Individual provider Active NPI

Jaynee Lee Fuller, ARNP

  • Nurse Practitioner
  • Blairsville, GA
National Provider Identifier
1700869773
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN227177 Issued in GA
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

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
30010894MedicaidNH

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

LicenseStateTypeSpecialty
9228873FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.