JESSICA MICHELLE FULKERSON MD
NPI 1164164695
Student in an Organized Health Care Education/Training Program in Louisville, KY

Q: What is Jessica Fulkerson's NPI number?

The NPI number for Jessica Fulkerson is 1164164695. It was assigned to this individual provider in the NPPES registry on April 13, 2022.

Q: What is Jessica Fulkerson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Fulkerson was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since April 13, 2022PECOS Enrolled

550 S JACKSON ST FL 3, LOUISVILLE, KY 40202(502) 852-5666(502) 852-8980 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 29, 2025, May 16, 2024, Apr 13, 2022 (3 updates tracked since 2022).

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About Jessica Michelle Fulkerson Md NPPES

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

JESSICA MICHELLE FULKERSON MD (NPI 1164164695) is an individual student in an organized health care education/training program in Louisville, Kentucky and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164164695

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJESSICA MICHELLE FULKERSONCredential: MD

Location Address550 S JACKSON ST FL 3Louisville, KY 40202-1622

Mailing Address6201 Greenleigh Ave Fl 2Middle River, MD 21220-2004 · (410) 933-2704 · Fax (410) 500-4266

Phone(502) 852-5666

Fax(502) 852-8980

Sole ProprietorNo

Enumeration DateApril 13, 2022

Last NPPES UpdateMay 29, 20253 updates tracked since enumeration

NPPES CertifiedMay 29, 2025

✔ NPI 1164164695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

550 S JACKSON ST FL 3, Louisville, KY 40202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Michelle Fulkerson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

HANNAH LYNN DEAL HARRISON DO

Internal Medicine (Hospice and Palliative Medicine)