DR. KEVIN L. FULFORD (MD) – Obstetrics & Gynecology Physician, NPI 1063594612
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. KEVIN L. FULFORD (MD)
400 N Highland Ave
Murfreesboro, TN 371303837
Phone: (615) 396-4100
Type: Location
Sharp Grossmont Hospital, 5555, Grossmont Center Drive, La Mesa, San Diego County, California, 91942, United States
LA MESA, CA 919423019
Phone: (619) 704-4966
Type: Location
250, Murray Drive, Fletcher Hills, El Cajon, San Diego County, California, 92020, United States
EL CAJON, CA 920204113
Phone: (423) 552-6924
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-08-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20121017000824 | I | Obstetrics/Gynecology | CA | TBD |
| I20200227002713 | I | Obstetrics/Gynecology | WY | TBD |
| I20210824001821 | I | Obstetrics/Gynecology | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37130)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| - | MD | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX |
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