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HALEY RENEE FULKERSON RD
NPI 1821281163
Dietitian, Registered in Leitchfield, KY

Active since August 21, 2007
912 WALLACE AVE STE 102, LEITCHFIELD, KY 42754(270) 259-8888 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 11, 2024, Dec 6, 2023 (2 updates tracked since 2023).

About Haley Renee Fulkerson Rd NPPES

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

HALEY RENEE FULKERSON RD (NPI 1821281163) is an individual dietitian, registered in Leitchfield, Kentucky, licensed in Kentucky (123904) and active in the NPI registry since August 2007. She maintains 5 additional practice locations.

NPPES Registry Identity

NPI1821281163
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameHALEY RENEE FULKERSONCredential: RD
Location Address912 WALLACE AVE STE 102Leitchfield, KY 42754-2405
Mailing AddressPo Box 776879Chicago, IL 60677-6879 · (502) 559-9407 · Fax (502) 272-5339
Phone(270) 259-8888
Sole ProprietorNo
Enumeration DateAugust 21, 2007
Last NPPES UpdateDecember 11, 20242 updates tracked since enumeration
NPPES CertifiedDecember 11, 2024
✔ NPI 1821281163 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 KY · 123904
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.
912 WALLACE AVE STE 102, Leitchfield, KY 42754
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Secondary Practice Locations 5

Location 11213 N Main StBeaver Dam, KY 42320-8955 · Phone (270) 274-4771 · Fax (270) 274-4884
Location 2811 E Parrish Ave Ste 102Owensboro, KY 42303-3258 · Phone (270) 688-2077 · Fax (270) 688-2078
Location 32025 W Everly Brothers Blvd Ste 2APowderly, KY 42367-5401 · Phone (270) 377-2626 · Fax (270) 377-2777
Location 42025 W Everly Brothers Blvd Ste 1APowderly, KY 42367-5401 · Phone (270) 377-2600
Location 5411 E Chestnut St # 5A6BLouisville, KY 40202-1713 · Phone (502) 588-9490 · Fax (502) 588-7712

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Haley Renee Fulkerson Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Haley Fulkerson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Owensboro Health Medical Group, Inc
Same address
Family Medicine
912 WALLACE AVE STE 102
Leitchfield, KY 42754
  • Reassigned Medicare billing, Kentucky enrollment
  • 643 clinicians in this Medicare group
NPI 1093302416 (270) 259-8888
Norton Children's Medical Group, LLC
70 mi
Clinical Genetics (M.D.)
4803 OLYMPIA PARK PLZ STE 1100
Louisville, KY 40241
  • Reassigned Medicare billing, Kentucky enrollment
  • Medicare enrollment name: Norton Childrens Medical Group LLC
  • 1,008 clinicians in this Medicare group
NPI 1013559921 (502) 272-5336

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

Other Providers at the Same Location NPPES 5

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

PRIYANK CHAUHAN MD
Internal Medicine (Geriatric Medicine)
912 WALLACE AVE STE 102
LEITCHFIELD, KY 42754
Grayson County (270) 259-8888
OWENSBORO HEALTH MEDICAL GROUP, INC
Family Medicine
912 WALLACE AVE STE 102
LEITCHFIELD, KY 42754
Grayson County (270) 259-8888
ANN ELIZABETH SIMMONS RDN
Dietitian, Registered
912 WALLACE AVE STE 102
LEITCHFIELD, KY 42754
Grayson County (270) 259-8888
DR. IVAN ALEXANDER ESCUDERO MD
Family Medicine
912 WALLACE AVE STE 102
LEITCHFIELD, KY 42754
Grayson County (270) 259-8888
MR. STEVEN BLAKE CLEMONS APRN
Nurse Practitioner (Family)
912 WALLACE AVE STE 102
LEITCHFIELD, KY 42754
Grayson County (270) 259-8888

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 Haley Fulkerson's NPI number?

The NPI number for Haley Fulkerson is 1821281163. It was assigned to this individual provider in the NPPES registry on August 21, 2007.

Where is Haley Fulkerson located?

Haley Fulkerson practices at 912 Wallace Ave Ste 102, Leitchfield, KY 42754. The listed phone number is (270) 259-8888.

What is Haley Fulkerson's specialty?

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

Is Haley Fulkerson enrolled in Medicare?

Yes. Haley Fulkerson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Haley Fulkerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Haley Fulkerson reassigns Medicare benefits to 2 organizations: Owensboro Health Medical Group, Inc (Leitchfield, KY) and Norton Children's Medical Group, LLC (Louisville, KY). Each 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 Haley Fulkerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Haley Fulkerson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Haley Fulkerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Haley Fulkerson was last updated on December 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.