MARY JANE FULLWOOD (MD) – Family Medicine Physician, NPI 1306208954
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,211 FAMILY PRACTICE in TN
Provider Addresses for MARY JANE FULLWOOD (MD)
220 Oakgrove Rd
Selmer, TN 38375
Phone: (731) 646-3699
Fax: (731) 646-3687
Type: Location
217, Hickory Street, Adamsville, McNairy County, Tennessee, 38310, United States
ADAMSVILLE, TN 383102033
Phone: (731) 607-7484
Type: Mailing
832 MULBERRY AVE
SELMER, TN 383752334
Phone: (731) 434-0200
Fax: (731) 434-0203
Type: Mailing
832, Mulberry Avenue, Selmer, McNairy County, Tennessee, 38375, United States
SELMER, TN 383752334
Phone: (731) 434-0200
Fax: (731) 434-0203
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 190 Open Payments records for all available years, with a total value of $3,593.
Total Amount is formed as General ($3,593) + Research ($0) + Ownership ($0) = $3,593.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,000).
Total Amount
$3,593
General + Research + Ownership
Payments
190
Total payment records
General Amount
$3,593
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,000 |
| Novo Nordisk Inc | $486 |
| Amgen Inc. | $434 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $200 |
| Teva Pharmaceuticals USA, Inc. | $121 |
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: 2019-10-30
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191030000848 | I | Family Practice | TN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 47 | 20 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 26 | 20 | $0 |
| 81003 | Automated urinalysis test | 25 | 16 | $0 |
Insurance plans in this area (ZIP 38375)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN |
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