Jennifer N Fuller

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

61899 M 43
Bangor, MI 49013-9621

Phone

(269) 427-5671

NPI assigned

Apr 21, 2026

Last updated

Apr 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 names 1

• Jennifer Beaty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

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  NPD (past)

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1982549515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61899 M 43",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490139621",
            "telephone_number": "269-427-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61899 M 43",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490139621",
            "telephone_number": "269-427-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JENNIFER",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BEATY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caralyn Dehaan, D.O.
• Engedi Homes, Inc.
• Terryl Ensign, R.PH
• Rebekah Lee Fatzinger, LLP, LMSW
• Leroy Freeman Jr., LLBSW
• Araceli Garcia, CHW
• Audria Gilliland, RN
• Terri Lynn Harbin Ilg, RDH
• Rickie Lynn Hernandez
• Craig Michael Herrmann, D.D.S.

• Case Manager/Care Coordinator in Bangor, MI
• Providers in Bangor, MI by specialty
• Case Manager/Care Coordinator in Michigan

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