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BETHANY TILLMAN FULLER MD
NPI 1225888530
Emergency Medicine in Jackson, MS

Active since March 27, 2024PECOS Enrolled
2500 N STATE ST, JACKSON, MS 39216(601) 984-5570 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bethany Tillman Fuller Md NPPES

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

BETHANY TILLMAN FULLER MD (NPI 1225888530) is an individual emergency medicine provider in Jackson, Mississippi, licensed in Mississippi (T-5502) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225888530
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameBETHANY TILLMAN FULLERCredential: MD
Location Address2500 N STATE STJackson, MS 39216-4500
Mailing Address2500 N State StJackson, MS 39216-4500
Phone(601) 984-5570
Sole ProprietorNo
Enumeration DateMarch 27, 2024
Last NPPES UpdateJuly 3, 2024
NPPES CertifiedJuly 3, 2024
✔ NPI 1225888530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MS · T-5502
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2500 N STATE ST, Jackson, MS 39216
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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)

Bethany Tillman Fuller 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LAMAR DAVIS II M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5275
STEPHEN COMMISKEY M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
JESSICA SAFLEY MD
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
DR. MARY KINNEY LOWE CORLEY MD
Obstetrics & Gynecology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5339
LAURA ELIZABETH VEARRIER M.D.
Emergency Medicine
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 815-2005
DR. CANDICE BRITTANY APRIL DDS
Dentist
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-6028
DR. LARKIN H MITCHELL M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
EMILY SUMRALL CHILDRESS CRNA
Nurse Anesthetist, Certified Registered
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-1000

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 Bethany Fuller's NPI number?

The NPI number for Bethany Fuller is 1225888530. It was assigned to this individual provider in the NPPES registry on March 27, 2024.

Where is Bethany Fuller located?

Bethany Fuller practices at 2500 N State St, Jackson, MS 39216. The listed phone number is (601) 984-5570.

What is Bethany Fuller's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Bethany Fuller enrolled in Medicare?

Yes. Bethany Fuller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bethany Fuller was last updated on July 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.