Tenikqua Fullwood-Maple, PMHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

31415 Issued in SC

Practice address

1278 N Lafayette Dr
Sumter, SC 29150-2964

Phone

(803) 774-4500

NPI assigned

Jan 30, 2026

Last updated

Jan 30, 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

Medicare fee-for-service enrollment

Enrolled in SC

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tandem Health SCGroup PAC ID 3870575855, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1649035841
  Medicare reassignment Care Compare group NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1386630192
  Medicare reassignment
• Tandem Health SC

  dba Tandem Health

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1740641919
  NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1821885583
  NPD

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1932059888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 SANDHILL DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291545316",
            "telephone_number": "803-774-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 N LAFAYETTE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502964",
            "telephone_number": "803-774-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLWOOD-MAPLE",
        "first_name": "TENIKQUA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "31415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care Cna Kidney Centers, LLC (Fresenius Medical Care Swan Lake Dialysis Center)
• Fresenius Medical Care Cna Kidney Centers, LLC (Fresenius Medical Care Sumter Home)
• Joshua Frey, DPT
• Duangmani Friday, DC
• Lindsay Frost, PHARMD
• Willie Benjamin Funnye
• Matthew J Furman, D.O.
• Fiona Gable, PHARMD
• Regan Gaddy-Kates
• Breanna Gadson

• Nurse Practitioner in Sumter, SC
• Providers in Sumter, SC by specialty
• Nurse Practitioner in South Carolina

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