DESTINY MARIE FULLEN
NPI 1588517619
Nurse Practitioner - Primary Care in Bardstown, KY

Q: What is Destiny Fullen's NPI number?

The NPI number for Destiny Fullen is 1588517619. It was assigned to this individual provider in the NPPES registry on February 18, 2026.

Q: What is Destiny Fullen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Destiny Fullen was last updated on March 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 February 18, 2026PECOS EnrolledAccepts Medicare Assignment

102 W JOHN ROWAN BLVD, BARDSTOWN, KY 40004(502) 348-7880 Get Directions Write a Review

NPPES record last updated: March 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Destiny Marie Fullen NPPES

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

DESTINY MARIE FULLEN (NPI 1588517619) is an individual primary care provider in Bardstown, Kentucky, licensed in Kentucky (4047688) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1588517619

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameDESTINY MARIE FULLEN

Location Address102 W JOHN ROWAN BLVDBardstown, KY 40004-2663

Mailing Address108 Brookshade DrMount Washington, KY 40047-5583 · (502) 759-0635

Phone(502) 348-7880

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateFebruary 18, 2026

Last NPPES UpdateMarch 7, 2026

NPPES CertifiedMarch 7, 2026

✔ NPI 1588517619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in KY · 4047688

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 4047688 (KY)

102 W JOHN ROWAN BLVD, Bardstown, KY 40004

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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 and accepts Medicare assignment

Destiny Marie Fullen 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 ID6507340692

PECOS Enrollment IDI20260317002769

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 40004 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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 9

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

KROGER LIMITED PARTNERSHIP I

Pharmacy (Community/Retail Pharmacy)