Jennifer L Fullerton

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

004979 Issued in GA

Practice address

1103 Russell Pkwy
Warner Robins, GA 31088-5537

Phone

(478) 922-4091

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Smith Spinal Care PC

  • Chiropractor
  • Warner Robins, GA
  • NPI 1770911380
  NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1982226908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WATER FRONT DR",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310306007",
            "telephone_number": "478-396-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885537",
            "telephone_number": "478-922-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "004979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Fruge, CNM
• Full Destiny Counseling, LLC (Heather W Prunty)
• Ava Fuller
• Brenda Chiquita Fuller
• Katelyn Fuller, PHARMD
• Robb L Fulton, D.O.
• Selvi Fults, NP-C
• Daniel Oliver Fussell, M.D.
• Melvin Lee Christopher Fussell, M.D.
• Ga Doctors of Optometry LLC

• Massage Therapist in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.