DR. KENNETH DWAYNE FULKS (M.D.) – Plastic and Reconstructive Surgery Physician, NPI 1144237751

DR. KENNETH DWAYNE FULKS (M.D.) is a healthcare provider. based in Columbia, Tennessee. specializing in PLASTIC AND RECONSTRUCTIVE SURGERY. They hold the professional credentials M.D.. They hold a License No. MD019595 (TN). The NPI Number for DR. KENNETH DWAYNE FULKS (M.D.) is 1144237751

Main info

Male
Sole Proprietor
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH DWAYNE FULKS (M.D.)
NPI
1144237751
Phone
(931) 381-2802
Address
1601 HATCHER LN
Enumeration Date
3 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9313811111
Graduation Year
1985 (41 years ago)
PAC ID
3971637463
Group Practice PAC ID
7911810742
Professional Enrollment ID
I20100819000628
Address ID
TN384014802CO1224XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

142 PLASTIC AND RECONSTRUCTIVE SURGERY in TN

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Provider Addresses for DR. KENNETH DWAYNE FULKS (M.D.)

  • 1601, Hatcher Lane, West Meade, Columbia, Maury County, Middle Tennessee, Tennessee, 38401, United States

    COLUMBIA, TN 384014826

    Phone: (931) 381-2802

    Fax: (931) 388-0719

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $102.

Total Amount is formed as General ($102) + Research ($0) + Ownership ($0) = $102.

Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Mentor Worldwide LLC ($70).

Total Amount

$102

General + Research + Ownership

Payments

6

Total payment records

General Amount

$102

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2010-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100819000628IPlastic And Reconstructive SurgeryTNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99203New patient office or other outpatient visit, 30-44 minutes7878$0
99212Established patient office or other outpatient visit, 10-19 minutes6238$0
14060Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less6158$0
99213Established patient office or other outpatient visit, 20-29 minutes4945$0
99202New patient office or other outpatient visit, 15-29 minutes3232$0
View full utilization report →

Insurance plans in this area (ZIP 38401)

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Provider's Procedures

DR. KENNETH DWAYNE FULKS (M.D.) performs procedures in PLASTIC AND RECONSTRUCTIVE SURGERY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PLASTIC AND RECONSTRUCTIVE SURGERYTN14060Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips6056

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911810742View full group profile
NameSpecialtyState
Nurse PractitionerNC
Internal MedicineTN
Anesthesiology, Pain ManagementAL
U R O L O G YFL
Pediatric Medicine, Internal MedicineTN
Internal Medicine, Pediatric MedicineLA
O B S T E T R I C S/ G Y N E C O L O G YSC
-TN
Otolaryngology, Allergy/ImmunologyTN
U R O L O G YGA

Reviews

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Frequently asked questions

How do I look up DR. KENNETH DWAYNE FULKS (M.D.) by NPI?
Use NPI 1144237751 when you need to reference DR. KENNETH DWAYNE FULKS (M.D.) in forms, claims, or directories.
Is DR. KENNETH DWAYNE FULKS (M.D.) currently active in the NPI registry?
CMS-published data lists DR. KENNETH DWAYNE FULKS (M.D.) as an active registrant.
What field does DR. KENNETH DWAYNE FULKS (M.D.) work in?
You can think of DR. KENNETH DWAYNE FULKS (M.D.) as practicing within Plastic and Reconstructive Surgery Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. KENNETH DWAYNE FULKS (M.D.)?
The page summarizes Columbia, Tennessee for DR. KENNETH DWAYNE FULKS (M.D.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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