Jaclyn Nicole Fuller, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-108712 Issued in AL

Practice address

1010 1St Street North
Suite 112
Alabaster, AL 35007

Phone

(205) 663-1023

Fax

(205) 870-7107

NPI assigned

Nov 30, 2011

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

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastroenterology Associates of North-Central Alabama IncGroup PAC ID 3072591478, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shelby Baptist Medical Center Hospital, Alabaster, AL, CCN 010016
• St Vincent'S Chilton Hospital, Clanton, AL, CCN 010173

Merit-based Incentive Payment System (MIPS)

Final score

81.6 of 100Reported as group

Quality

61.85

Promoting interoperability

97

Improvement activities

40

Cost

79.3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclyn.fuller@gastrohealth.eclinicaldirectplus.com

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.

• Gastroenterology Associates of North-Central Alabama Inc

  • Specialist
  • Birmingham, AL
  • NPI 1528080595

  AL

  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates of North-Central Alabama Inc

  • Anesthesiology Physician
  • Birmingham, AL
  • NPI 1912446105
  NPD

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

• BBH SBMC, LLC

  • General Acute Care Hospital
  • Alabaster, AL
  • NPI 1811341167

  Hospital

  Care Compare affiliation
• St Vincents Chilton LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Clanton, AL
  • NPI 1013365824

  Hospital

  Care Compare affiliation
• St Vincents Chilton LLC

  • General Acute Care Hospital
  • Clanton, AL
  • NPI 1093171860

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1851668271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BROOKWOOD BLVD",
            "address_2": "SUITE 401",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-870-0256",
            "fax_number": "205-870-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 1ST STREET NORTH",
            "address_2": "SUITE 112",
            "city": "ALABASTER",
            "state": "AL",
            "postal_code": "35007",
            "telephone_number": "205-663-1023",
            "fax_number": "205-870-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-108712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Michelle Fowler
• Taylor Francis, DDS
• Mark A Franks, DPT
• Tanya R. Franks, C.R.N.A.
• William Lewis Fulcher, MD
• Joseph H Fulmer III, CRNA
• Krishna Kishore Gaddam, M.D
• Jennifer Gafnea, CRNP
• Molly Colquitt Gambill, PHARMD
• James L Gann, RPH

• All providers in Alabaster, AL
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.