Individual provider Active NPI

Gretchen L Fulkerson, APRN

  • Family Nurse Practitioner
  • New Braunfels, TX
National Provider Identifier
1720356256
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1052882 Issued in TX
Practice address
1761 State Highway 46 S Ste 104
New Braunfels, TX 78130-2237
Phone
(830) 433-7815
NPI assigned
Dec 12, 2011
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1052882 TX Primary

Addresses

Primary practice location

1761 State Highway 46 S Ste 104
New Braunfels, TX 78130-2237

Mailing address

1761 State Highway 46 S Ste 104
New Braunfels, TX 78130-2237
Phone (830) 433-7815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802000456 TX Practitioner - Nurse Practitioner 0446480610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guadalupe Regional Medical GroupGroup PAC ID 6800077694, 38 clinicians

Practice addresses (Care Compare)

1761 S State Hwy 46
Suite 104
New Braunfels, TX 78130-2237
Phone (830) 401-7558

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guadalupe Regional Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Guadalupe Regional Medical Group Current Accepting new patients
Guadalupe County Hospital Board Past Accepting new patients

Locations

1761 State Highway 46 S
Ste 104
New Braunfels, TX 78130
Phone (830) 401-7558

1215 E Court St
Seguin, TX 78155
Phone (830) 379-2411

Interoperability endpoints

  • Direct secure messaging: gretchen.fulkerson.1@27064.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27064/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1720356256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 STATE HIGHWAY 46 S STE 104",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302237",
            "telephone_number": "830-433-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 STATE HIGHWAY 46 S STE 104",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302237",
            "telephone_number": "830-433-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "GRETCHEN",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1052882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.