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CHRISTINA FULLEM RDN
NPI 1306424619
Dietitian, Registered in Poland, NY

Active since March 30, 2021
8714 S MAIN ST, POLAND, NY 13431(315) 292-8285 Get Directions Write a Review

NPPES record last updated: March 30, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Christina Fullem Rdn NPPES

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

CHRISTINA FULLEM RDN (NPI 1306424619) is an individual dietitian, registered in Poland, New York, licensed in New York (940276) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1306424619
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameCHRISTINA FULLEMCredential: RDN
Location Address8714 S MAIN STPoland, NY 13431-2302
Mailing Address8714 S Main StPoland, NY 13431-2302
Phone(315) 292-8285
Sole ProprietorYes
Enumeration DateMarch 30, 2021
NPPES CertifiedMarch 30, 2021
✔ NPI 1306424619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in NY · 940276
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
8714 S MAIN ST, Poland, NY 13431
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Christina Fullem Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Christina Fullem reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

State Of New York Comptrollers Office
52 mi
Developmental Disabilities
6007 FAIR LAKES RD, SUITE 500
East Syracuse, NY 13057
  • Reassigned Medicare billing, New York enrollment
  • 342 clinicians in this Medicare group
NPI 1114067915 (315) 473-5050

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

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 Christina Fullem's NPI number?

The NPI number for Christina Fullem is 1306424619. It was assigned to this individual provider in the NPPES registry on March 30, 2021.

Where is Christina Fullem located?

Christina Fullem practices at 8714 S Main St, Poland, NY 13431. The listed phone number is (315) 292-8285.

What is Christina Fullem's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Christina Fullem enrolled in Medicare?

Yes. Christina Fullem is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Christina Fullem's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Christina Fullem reassigns Medicare benefits to State Of New York Comptrollers Office (East Syracuse, NY). The 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 Christina Fullem's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Christina Fullem was last updated on March 30, 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.