NPIMap

Individual provider Active NPI

Douglas Middleton Bull, M.D.

  • Diagnostic Radiology Physician
  • Greenville, SC
National Provider Identifier
1023066255
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11386 Issued in SC
Practice address
1210 W Faris Rd
Greenville, SC 29605-4444
Phone
(864) 522-1800
Fax
(864) 522-1806
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11386 SC Primary

Addresses

Primary practice location

1210 W Faris Rd
Greenville, SC 29605-4444

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other practice location 1

1519 Marion St
Columbia, SC 29220-0001
Phone (803) 296-5954

Other identifiers 1

IdentifierTypeStateIssuer
113861MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110222000604 SC Practitioner - Diagnostic Radiology 2466466123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical Group 2,467 clinicians

Practice addresses (Care Compare)

1210 W Faris Rd
Greenville, SC 29605-4444
Phone (864) 522-1800

1519 Marion St
Columbia, SC 29201-2910
Phone (803) 296-5954

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Newberry County Memorial Hospital Hospital, Newberry, SC, CCN 420053
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11386SCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Oct 2, 2020 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 29, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 30, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Sep 17, 2025 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Oct 2, 2020 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Feb 27, 2021 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Sep 10, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Feb 9, 2026 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Aug 8, 2025 Accepting new patients
Providence Orthopaedic Group LLC Past Accepting new patients
Nimco L.L.C Past Accepting new patients

Locations

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

1519 Marion St
Columbia, SC 29201
Phone (803) 296-5513

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: dbull61362@direct.ghs.myhfn.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1023066255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054444",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 Marion St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292200001",
            "country_code": "US",
            "telephone_number": "803-296-5954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULL",
        "first_name": "DOUGLAS",
        "middle_name": "MIDDLETON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "11386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113861",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.