DR. JERYL GLYNN FULLEN M.D.
NPI 1275631020
Orthopaedic Surgery in Logansport, IN

Active since September 20, 2006PECOS Enrolled
1101 MICHIGAN AVE, LOGANSPORT, IN 46947(574) 753-1729 Get Directions Write a Review

NPPES record last updated: January 16, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jeryl Glynn Fullen M.d. NPPES

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

DR. JERYL GLYNN FULLEN M.D. (NPI 1275631020) is an individual orthopaedic surgery provider in Logansport, Indiana, licensed in Indiana (01063517A) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275631020
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. JERYL GLYNN FULLENCredential: M.D.
Location Address1101 MICHIGAN AVELogansport, IN 46947-1528
Mailing Address1101 Michigan AveLogansport, IN 46947-1528 · (574) 753-1729
Sole ProprietorNo
Enumeration DateSeptember 20, 2006
Last NPPES UpdateJanuary 16, 2014
NPI 1275631020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses Licensed in IN · 01063517A Licensed in KS · 04-16478
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1101 MICHIGAN AVE, Logansport, IN 46947

Other Identifiers 7

Medicare PINM400035965IN
Medicare UPINB91140KS
Medicaid200993900IN
Medicare ID-Type Unspecified019741KS
Other5N934AR · Medicare Ptan
Other000000696600IN · Anthem
Medicaid100118960AKS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jeryl Glynn Fullen M.d. 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 46947 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
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.

Physician Assistant
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Registered Nurse
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Emergency Medicine
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Pharmacist
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Emergency Medicine
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Emergency Medicine
1101 MICHIGAN AVE
LOGANSPORT, IN 46947
Emergency Medicine
1101 MICHIGAN AVE
LOGANSPORT, IN 46947

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 Jeryl Fullen's NPI number?

The NPI number for Jeryl Fullen is 1275631020. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Jeryl Fullen located?

Jeryl Fullen practices at 1101 Michigan Ave, Logansport, IN 46947. The listed phone number is (574) 753-1729.

What is Jeryl Fullen's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Jeryl Fullen enrolled in Medicare?

Yes. Jeryl Fullen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeryl Fullen was last updated on January 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.