Mrs Nicole Shupe Fullard, NP in Brunswick, GA

Mrs Nicole Shupe Fullard, NP is a medicare enrolled "Nurse Practitioner - Family" in Brunswick, Georgia. Her current practice location is 1111 Glynco Pkwy Ste 10, Brunswick, Georgia. You can reach out to her office (for appointments etc.) via phone at (912) 264-9111.

Mrs Nicole Shupe Fullard is licensed to practice in Georgia (license number RN231483) 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 1225660491.

Contact Information

	Mrs Nicole Shupe Fullard, NP
	1111 Glynco Pkwy Ste 10, Brunswick, GA 31525-7930
	(912) 264-9111
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Nicole Shupe Fullard
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1111 Glynco Pkwy Ste 10, Brunswick, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225660491
Provider Enumeration Date: 02/06/2020
Last Update Date: 02/11/2020

Medicare PECOS Information:

PECOS PAC ID: 6406277722
Enrollment ID: I20200522000059

Medical Identifiers

Medical identifiers for Mrs Nicole Shupe Fullard such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225660491	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN231483 (Georgia)	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 Nicole Shupe Fullard allows following entities to bill medicare on her behalf.

Entity Name	Peachtree Immediate Care Fp, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437194156 PECOS PAC ID: 3274559323 Enrollment ID: O20051019000049

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 Nicole Shupe Fullard 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 Nicole Shupe Fullard, NP 210 Evelyn Dr, Brunswick, GA 31523-1111 Ph: (912) 275-7500	Mrs Nicole Shupe Fullard, NP 1111 Glynco Pkwy Ste 10, Brunswick, GA 31525-7930 Ph: (912) 264-9111

Reviews and Comments

Nurse Practitioner Nurses in Brunswick, GA

Lindsey Hodges Bell, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 Gable Ct, Brunswick, GA 31525 Phone: 912-466-5870 Fax: 912-267-4749
Ashley Danielle Head, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1692 Glynco Pkwy, Brunswick, GA 31525 Phone: 912-265-4735 Fax: 912-265-6100
Haley Rebecca Walling, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2415 Parkwood Dr, Brunswick, GA 31520 Phone: 912-292-2643
Jasmine Marie Hahn, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3025 Shrine Rd Ste 270, Brunswick, GA 31520 Phone: 912-262-2723
Elizabeth K Watson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2916 Glynn Ave, Brunswick, GA 31520 Phone: 912-466-5850 Fax: 912-466-5881
Courtney Dowling, MSN, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2747 4th St, Brunswick, GA 31520 Phone: 912-288-6766
Kimberly Ann Kirk, AGACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3025 Shrine Rd Ste 270, Brunswick, GA 31520 Phone: 912-262-2723

Mrs Nicole Shupe Fullard, NP - Medicare Nurse Practitioner in Brunswick, GA