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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MR. JACK ANTHONY FULLING PA
NPI 1972411387
Physician Assistant in Ooltewah, TN

Active since August 28, 2026
6059 ARBURY WAY, OOLTEWAH, TN 37363(423) 559-6000 Get Directions Write a Review

NPPES record added: August 28, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mr. Jack Anthony Fulling Pa NPPES

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

MR. JACK ANTHONY FULLING PA (NPI 1972411387) is an individual physician assistant in Ooltewah, Tennessee and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1972411387
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JACK ANTHONY FULLINGCredential: PA
Location Address6059 ARBURY WAYOoltewah, TN 37363-5001
Mailing Address950 Tapestry WayKnoxville, TN 37932-3522 · (423) 559-6000
Phone(423) 559-6000
Sole ProprietorYes
Enumeration DateAugust 28, 2026
NPPES CertifiedAugust 28, 2026
✔ NPI 1972411387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
6059 ARBURY WAY, Ooltewah, TN 37363
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Other Providers at the Same Location NPPES 4

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

VIRGINIA WEIR
Physician Assistant
6059 ARBURY WAY
OOLTEWAH, TN 37363
Hamilton County (423) 238-8880
MELISSA LEDEZMA-ORTIZ FNP
Nurse Practitioner (Family)
6059 ARBURY WAY
OOLTEWAH, TN 37363
Hamilton County (505) 818-9095
DR. KARISTEN ROCHELLE DJERNES M.D.
Family Medicine
6059 ARBURY WAY, STE 101
OOLTEWAH, TN 37363
Hamilton County (423) 238-8880
TAYLOR GAREIS
Physician Assistant
6059 ARBURY WAY
OOLTEWAH, TN 37363
Hamilton County (423) 238-8880

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 Jack Fulling's NPI number?

The NPI number for Jack Fulling is 1972411387. It was assigned to this individual provider in the NPPES registry on August 28, 2026.

Where is Jack Fulling located?

Jack Fulling practices at 6059 Arbury Way, Ooltewah, TN 37363. The listed phone number is (423) 559-6000.

What is Jack Fulling's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jack Fulling was last updated on August 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days 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.