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

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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 16 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 NameMrs Kimberly Fuller
GenderFemale
SpecialityNurse Practitioner
Experience16 Years
Location2100 Highway 61 N, Vicksburg, Mississippi
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1083860324NPI-NPPES
07281200MedicaidMS
1347574MedicaidLA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care R853474 (Mississippi)Primary
207P00000XEmergency Medicine R853474 (Mississippi)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Quad Intermed Company Llc670924595450

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 NameMississippi Physicians Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902174832
PECOS PAC ID: 7113193855
Enrollment ID: O20111230000560
Entity NameMea Primary Care Plus, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750826210
PECOS PAC ID: 0941583728
Enrollment ID: O20170202001116
Entity NameApp Of Mississippi Ed Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730687740
PECOS PAC ID: 3971865858
Enrollment ID: O20180313002534
Entity NameRelias Emergency Medicine Specialists Of St Dominic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235808122
PECOS PAC ID: 2466840152
Enrollment ID: O20211029000889
Entity NameQuad Intermed Company Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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


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Practice Location: 2011 Highway 61 N, Vicksburg, MS 39183
Phone: 014-562-2776    Fax: 601-456-2622

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.