Individual provider Active NPI

Douglas K Bullington, MD

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1043383276
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01029416 Issued in IN
Practice address
3000 S State Road 135
Suite 200
Greenwood, IN 46143-9825
Phone
(317) 535-1876
Fax
(317) 535-5049
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01029416 IN Primary

Addresses

Primary practice location

3000 S State Road 135
Suite 200
Greenwood, IN 46143-9825

Mailing address

1155 W Jefferson St
Suite 101
Franklin, IN 46131-2730
Phone (317) 736-6133

Other practice location 1

1155 W Jefferson St Ste 101
Franklin, IN 46131-2731
Phone (317) 736-6133

Other identifiers 1

IdentifierTypeStateIssuer
080001659OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01029416INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1043383276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 W JEFFERSON ST",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312730",
            "telephone_number": "317-736-6133",
            "fax_number": "317-736-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S STATE ROAD 135",
            "address_2": "SUITE 200",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439825",
            "telephone_number": "317-535-1876",
            "fax_number": "317-535-5049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 W Jefferson St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "IN",
            "postal_code": "461312731",
            "country_code": "US",
            "telephone_number": "317-736-6133",
            "fax_number": "317-736-6133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLINGTON",
        "first_name": "DOUGLAS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01029416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080001659",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.