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

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Miss Charisse N Fullwood, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Raleigh, North Carolina. Her current practice location is 3200 Blue Ridge Rd Ste 218, Raleigh, North Carolina. You can reach out to her office (for appointments etc.) via phone at (910) 713-8209.

Miss Charisse N Fullwood is licensed to practice in North Carolina (license number 0000000) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1154085629.

Contact Information

Miss Charisse N Fullwood, PMHNP-BC
3200 Blue Ridge Rd Ste 218,
Raleigh, NC 27612-8087
(910) 713-8209
Not Available

Map and Direction




Provider's Profile

Full NameMiss Charisse N Fullwood
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location3200 Blue Ridge Rd Ste 218, Raleigh, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1154085629
  • Provider Enumeration Date: 10/29/2021
  • Last Update Date: 05/21/2026
  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.
IdentifierTypeStateIssuer
1154085629NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 0000000 (North Carolina)Primary

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 NameFreedom House Recovery Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093986523
PECOS PAC ID: 5193898229
Enrollment ID: O20090619000344
Entity NamePave Behavioral Health Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699173294
PECOS PAC ID: 8527384890
Enrollment ID: O20150303002344
Entity NameTriangle Springs Physician Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063901312
PECOS PAC ID: 7214283266
Enrollment ID: O20180703003145
Entity NameStep Up Care Of North Carolina Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841929395
PECOS PAC ID: 4486036878
Enrollment ID: O20220802000558
Entity NameTriad Counseling & Clinical Service Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619988938
PECOS PAC ID: 1557734332
Enrollment ID: O20230224002423

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 AddressPractice Location Address
Miss Charisse N Fullwood, PMHNP-BC
3200 Blue Ridge Rd Ste 218,
Raleigh, NC 27612-8087

Ph: (910) 713-8209		Miss Charisse N Fullwood, PMHNP-BC
3200 Blue Ridge Rd Ste 218,
Raleigh, NC 27612-8087

Ph: (910) 713-8209

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.