Mrs Jessica Fultz, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in King City, Missouri. Her current practice location is
305 Rhode Island St, King City, Missouri. You can reach out to her office (for appointments etc.) via phone at
(913) 638-1348.
Mrs Jessica Fultz is licensed to practice in Missouri (license number F01241111) 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 1306603485.
Provider's Profile
| Full Name | Mrs Jessica Fultz |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 305 Rhode Island St, King City, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1306603485
- Provider Enumeration Date: 03/05/2024
- Last Update Date: 10/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 6800327248
- Enrollment ID: I20241009001602
Medical Identifiers
Medical identifiers for Mrs Jessica Fultz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306603485 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | F01241111 (Missouri) | 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. Mrs Jessica Fultz allows following entities to bill medicare on her behalf.
| Entity Name | Northwest Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467497677
PECOS PAC ID: 7113835174
Enrollment ID: O20040720001347 |
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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 Jessica Fultz 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 Jessica Fultz, FNP-C
305 Rhode Island St,
King City, MO 64463-9622
Ph: () - | Mrs Jessica Fultz, FNP-C
305 Rhode Island St,
King City, MO 64463-9622
Ph: (913) 638-1348 |
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