Kimberly Tillman Fulmer

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN139827 Issued in GA

Practice address

34 NW Broad St
Metter, GA 30439-4025

Phone

(912) 685-4040

NPI assigned

Oct 24, 2021

Last updated

Jan 21, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• East Georgia Healthcare Center, Inc.

  dba Swainsboro Elementary School

  • Federally Qualified Health Center (FQHC)
  • Swainsboro, GA
  • NPI 1194569228
  Medicare reassignment NPD
• East Georgia Healthcare Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stillmore, GA
  • NPI 1528658911
  NPD
• East Georgia Healthcare Center, Inc.

  dba Emanuel County Institute

  • Federally Qualified Health Center (FQHC)
  • Twin City, GA
  • NPI 1568330652
  NPD
• East Georgia Healthcare Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Swainsboro, GA
  • NPI 1831144971
  NPD (past)

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

{
    "created_epoch": "1635033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1780348060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 BURTON AVE",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304393303",
            "telephone_number": "912-690-2652",
            "fax_number": "833-637-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NW BROAD ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394025",
            "telephone_number": "912-685-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "856 US Highway 1 S",
            "address_purpose": "LOCATION",
            "city": "Swainsboro",
            "state": "GA",
            "postal_code": "304014984",
            "country_code": "US",
            "telephone_number": "478-237-7022",
            "fax_number": "833-637-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULMER",
        "first_name": "KIMBERLY",
        "middle_name": "TILLMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-24",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN139827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780348060",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Georgia Preventative Health Specialists, LLC (East Georgia Compounding and Wellness)
• Tracy Edwards, LPC
• Susan Daughtry Ferrell, PH.D.
• Four Seasons Senior Living, LLC
• Sarah Annlee Freeman
• Michael Edward Gasiecki, D.C.
• Jason Andrew Glow, MD
• Sherry Ann Grant
• Tonya Campbell Harris, LPC
• Jessica Hendrix, OTR/L

• Nurse Practitioner in Metter, GA
• Providers in Metter, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.