Individual provider Active NPI

Melissa J. Fullerton, M.D.

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1982869855
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57927 Issued in TN
Practice address
1350 Concourse Ave Ste 142
Memphis, TN 38104-2020
Phone
(901) 272-0003
Fax
(901) 261-8836
NPI assigned
Jul 21, 2008
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57927 TN Primary

Addresses

Primary practice location

1350 Concourse Ave Ste 142
Memphis, TN 38104-2020

Mailing address

1350 Concourse Ave Ste 142
Memphis, TN 38104-2020
Phone (901) 272-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190209000105 TN Practitioner - Family Practice 3476724584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Church Health Center of Memphis IncGroup PAC ID 7517863392, 14 clinicians

Practice addresses (Care Compare)

1350 Concourse Ave
Suite 142
Memphis, TN 38104-2020
Phone (901) 272-0003

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93 of 100Reported as group
Quality
86.11
Improvement activities
40
Cost
85.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57927TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Church Health Center of Memphis Inc CurrentSince Jun 3, 2019 Accepting new patients

Locations

1350 Concourse Ave
Ste 142
Memphis, TN 38104
Phone (901) 272-0003

Interoperability endpoints

  • Direct secure messaging: melissa.fullertonmd.p1@direct.churchhealthcenter.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1982869855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CONCOURSE AVE STE 142",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042020",
            "telephone_number": "901-272-0003",
            "fax_number": "901-261-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONCOURSE AVE STE 142",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042020",
            "telephone_number": "901-272-0003",
            "fax_number": "901-261-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "MELISSA",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "57927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.