Mrs Kimberly Fuller, MSN, ACNP - BS in Vicksburg, MS

Mrs Kimberly Fuller, MSN, ACNP - BS is a medicare enrolled "Nurse Practitioner - Acute Care" in Vicksburg, Mississippi. She graduated from nursing school in 2008 and has 17 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Quad Intermed Company Llc and her current practice location is 2100 Highway 61 N, Vicksburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 883-5000.

Mrs Kimberly Fuller is licensed to practice in Mississippi (license number R853474) 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 1083860324.

Contact Information

	Mrs Kimberly Fuller, MSN, ACNP - BS
	2100 Highway 61 N, Vicksburg, MS 39183-8211
	(601) 883-5000
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kimberly Fuller
Gender	Female
Speciality	Nurse Practitioner
Experience	17 Years
Location	2100 Highway 61 N, Vicksburg, Mississippi
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:

Mrs Kimberly Fuller graduated from nursing school in 2008

NPI Data:

NPI Number: 1083860324
Provider Enumeration Date: 08/18/2008
Last Update Date: 03/16/2009

Medicare PECOS Information:

PECOS PAC ID: 6103994348
Enrollment ID: I20081001000441

Medical Identifiers

Medical identifiers for Mrs Kimberly Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083860324	NPI	-	NPPES
07281200	Medicaid	MS
1347574	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	R853474 (Mississippi)	Primary
207P00000X	Emergency Medicine	R853474 (Mississippi)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Amedisys Home Health Of Vicksburg	Vicksburg, MS	Home health agency
Merit Health River Region	Vicksburg, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Quad Intermed Company Llc	6709245954	37

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. Mrs Kimberly Fuller allows following entities to bill medicare on her behalf.

Entity Name	Mississippi Physicians Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902174832 PECOS PAC ID: 7113193855 Enrollment ID: O20111230000560

Entity Name	App Of Mississippi Ed Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730687740 PECOS PAC ID: 3971865858 Enrollment ID: O20180313002534

Entity Name	Relias Emergency Medicine Specialists Of St Dominic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235808122 PECOS PAC ID: 2466840152 Enrollment ID: O20211029000889

Entity Name	Quad Intermed Company Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952099913 PECOS PAC ID: 6709245954 Enrollment ID: O20230706000437

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. Mrs Kimberly Fuller 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
Mrs Kimberly Fuller, MSN, ACNP - BS 2100 Highway 61 N, Vicksburg, MS 39183-8211 Ph: (601) 883-5000	Mrs Kimberly Fuller, MSN, ACNP - BS 2100 Highway 61 N, Vicksburg, MS 39183-8211 Ph: (601) 883-5000

Reviews and Comments

Nurse Practitioner Nurses in Vicksburg, MS

Jenifer Justice, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1911 Mission 66 Ste B, Vicksburg, MS 39180 Phone: 014-562-5986 Fax: 855-830-3484
Mrs. Latasha Jackson Claiborne, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031
Nina Tomlinson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 807 Monroe St, Vicksburg, MS 39183 Phone: 601-636-4356
Linda Cheslek, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 807 Monroe St, Vicksburg, MS 39183 Phone: 601-636-4356
Kerrie Sanders- Smith, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4077 Pemberton Square Blvd, Vicksburg, MS 39180 Phone: 601-638-8600
Manivanh A Prudhomme, MSN, FNP-BC, AGACNP- Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2011 Highway 61 N, Vicksburg, MS 39183 Phone: 014-562-2776 Fax: 601-456-2622

Mrs Kimberly Fuller, MSN, ACNP - BS - Medicare Nurse Practitioner in Vicksburg, MS