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CHRYSTAL TARRYN FULLEN PSYD
NPI 1053768911
Clinical Neuropsychologist in Little Rock, AR

Active since May 20, 2016PECOS EnrolledAccepts Medicare Assignment
4301 W MARKHAM ST # 589, LITTLE ROCK, AR 72205(501) 526-8284 Get Directions Write a Review

NPPES record last updated: August 27, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 27, 2021, Jun 8, 2020, May 20, 2016 (3 updates tracked since 2016).

About Chrystal Tarryn Fullen Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRYSTAL TARRYN FULLEN PSYD (NPI 1053768911) is an individual clinical neuropsychologist in Little Rock, Arkansas, licensed in Arkansas (19-32AP-PL) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1053768911
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameCHRYSTAL TARRYN FULLENCredential: PSYD
Location Address4301 W MARKHAM ST # 589Little Rock, AR 72205-7101
Mailing Address4301 W Markham St # 589Little Rock, AR 72205-7101 · (501) 526-8284
Phone(501) 526-8284
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 20, 2016
Last NPPES UpdateAugust 27, 20213 updates tracked since enumeration
NPPES CertifiedAugust 27, 2021
✔ NPI 1053768911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in AR · 19-32AP-PL
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
4301 W MARKHAM ST # 589, Little Rock, AR 72205
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chrystal Tarryn Fullen Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204232358
PECOS Enrollment IDI20210915000813
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Chrystal Fullen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Arkansas For Medical Sciences
Same address
Advanced Practice Midwife
4301 W MARKHAM ST # 783
Little Rock, AR 72205
  • Reassigned Medicare billing, Arkansas enrollment
  • 2,038 clinicians in this Medicare group
NPI 1043372220 (501) 686-8000
Arkansas Health Group
3.4 mi
Physical Medicine & Rehabilitation
9501 BAPTIST HEALTH DRIVE, FIRST FLOOR
Little Rock, AR 72205
  • Reassigned Medicare billing, Arkansas enrollment
  • 16 clinicians in this Medicare group
NPI 1649365347 (501) 202-7395

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLIN CAPERTON
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
KELSEY SPRINKLES
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8120
MARGARET SUSAN PICKHARDT MD
Psychiatry & Neurology (Psychiatry)
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
DR. VARENYA NALLUR MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
DR. TARAHN TURNER MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
JOHN WINN
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
DR. NADIA KHAN MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148
MOLLY TIBBS MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 589
LITTLE ROCK, AR 72205
Pulaski County (501) 526-8148

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chrystal Fullen's NPI number?

The NPI number for Chrystal Fullen is 1053768911. It was assigned to this individual provider in the NPPES registry on May 20, 2016.

Where is Chrystal Fullen located?

Chrystal Fullen practices at 4301 W Markham St # 589, Little Rock, AR 72205. The listed phone number is (501) 526-8284.

What is Chrystal Fullen's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Chrystal Fullen enrolled in Medicare?

Yes. Chrystal Fullen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Chrystal Fullen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chrystal Fullen reassigns Medicare benefits to 2 organizations: University Of Arkansas For Medical Sciences (Little Rock, AR) and Arkansas Health Group (Little Rock, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chrystal Fullen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Chrystal Fullen accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Chrystal Fullen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Chrystal Fullen was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.