Ellie Fulgham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4001423 Issued in KY

Practice address

2607 Main St
Benton, KY 42025-7601

Phone

(731) 394-1145

NPI assigned

Jul 17, 2023

Last updated

Sep 1, 2023By 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

Medicare fee-for-service enrollment

Enrolled in KY

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pineville Community Health Center IncGroup PAC ID 5698009157, shared by 4 NPIs, 39 clinicians

Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall County Hospital Hospital, Benton, KY, CCN 181327

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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.

• Ultra Health LLC

  dba Ultra Health Provders

  • Geriatric Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1922469543

  KY

  Medicare reassignment Care Compare group NPD

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

• Marshall County Hospital District

  • Critical Access Hospital
  • Benton, KY
  • NPI 1568528594
  Care Compare affiliation

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1891474896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 US HIGHWAY 68 W",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420256636",
            "telephone_number": "270-205-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257601",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULGHAM",
        "first_name": "ELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4001423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• H W Ford, MD
• Lauren Nicole Ford, PHARMD
• Forte Family Practice PLLC
• Louis Forte, MD
• Kimberly Jill Frick, PT
• Cassie Garrison, OTR/L
• Wendy S. Gibson, O.D.
• Leigh S Gideon, DC
• Rhonda Goins, RPH
• Goldsboro Surgical Associates, PA

• Family Nurse Practitioner in Benton, KY
• Providers in Benton, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.