Individual provider Active NPI

Julayne Bullard, PA-C

  • Physician Assistant
  • Midland, MI
National Provider Identifier
1033638945
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008350 Issued in MI
Practice address
4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126
Phone
(989) 837-9400
NPI assigned
Sep 12, 2017
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008350 MI Primary

Addresses

Primary practice location

4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126

Mailing address

4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126
Phone (989) 837-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214001340 MI Practitioner - Physician Assistant 4789942095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4401 N Campus RDG Dr
Midland, MI 48640-6112
Phone (989) 837-9200

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

602 Beech St
Clare, MI 48617-1466
Phone (989) 488-5420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Aug 1, 2018 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 13, 2023 Accepting new patients
Hospitalist Physicians Medical Group of Michigan, PC CurrentSince Jun 3, 2018 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 13, 2023 Accepting new patients
Sparrow Ionia Hospital CurrentSince Aug 1, 2018 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4401 N Campus Ridge Dr
Ste LL110
Midland, MI 48640
Phone (989) 837-9400

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: jbullard137395@mymichiganhealth.midirect.net

Organizations & group practices 7

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1033638945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE LL110",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406126",
            "telephone_number": "989-837-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE LL110",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406126",
            "telephone_number": "989-837-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "JULAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.