Miss Charisse N Fullwood, PMHNP-BC in Raleigh, NC

Miss Charisse N Fullwood, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Raleigh, North Carolina. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mindpath Care Centers North Carolina Pllc, Triangle Springs Physician Group Llc and her current practice location is 10901 World Trade Blvd, Raleigh, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 372-4408.

Miss Charisse N Fullwood is licensed to practice in North Carolina (license number 0000000) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1154085629.

Contact Information

	Miss Charisse N Fullwood, PMHNP-BC
	10901 World Trade Blvd, Raleigh, NC 27617-4203
	(919) 372-4408
	Not Available

Map and Direction

Provider's Profile

Full Name	Miss Charisse N Fullwood
Gender	Female
Speciality	Nurse Practitioner
Experience	3 Years
Location	10901 World Trade Blvd, Raleigh, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Miss Charisse N Fullwood graduated from nursing school in 2021

NPI Data:

NPI Number: 1154085629
Provider Enumeration Date: 10/29/2021
Last Update Date: 12/06/2021

Medicare PECOS Information:

PECOS PAC ID: 9931593936
Enrollment ID: I20220308000163

Medical Identifiers

Medical identifiers for Miss Charisse N Fullwood such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154085629	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	0000000 (North Carolina)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mindpath Care Centers North Carolina Pllc	4688655517	84
Triangle Springs Physician Group Llc	7214283266	12

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Miss Charisse N Fullwood allows following entities to bill medicare on her behalf.

Entity Name	Mindpath Care Centers North Carolina Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508803214 PECOS PAC ID: 4688655517 Enrollment ID: O20040526001582

Entity Name	Triangle Springs Physician Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063901312 PECOS PAC ID: 7214283266 Enrollment ID: O20180703003145

Entity Name	Step Up Care Of North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841929395 PECOS PAC ID: 4486036878 Enrollment ID: O20220802000558

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Charisse N Fullwood is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Miss Charisse N Fullwood, PMHNP-BC 10901 World Trade Blvd, Raleigh, NC 27617-4203 Ph: (919) 372-4408	Miss Charisse N Fullwood, PMHNP-BC 10901 World Trade Blvd, Raleigh, NC 27617-4203 Ph: (919) 372-4408

Reviews and Comments

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Miss Charisse N Fullwood, PMHNP-BC - Medicare Nurse Practitioner in Raleigh, NC