Bullock Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002990A Issued in IN

Legal business name

BULLOCK OPTOMETRY PC

Practice address

2373 E Main St
Plainfield, IN 46168-2717

Phone

(317) 839-0713

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Carmen N Bullock, ODNPI 1437108685

Title

President

Phone

(317) 417-0603

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen N. Bullock, O. D.

  • Optometrist
  • Plainfield, IN
  • NPI 1437108685

  IN, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1043478027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 KINGSVIEW DR",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461582734",
            "telephone_number": "317-417-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 E MAIN ST",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682717",
            "telephone_number": "317-839-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLOCK OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-417-0603",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002990A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200918100A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200918100B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Brock, PHARM.D.
• Angela Brown, RBT
• Virginia Dawn Brown, LPN
• Kelsea Broyles, NP
• Alexis Brumfield, APN
• Carmen N. Bullock, O. D.
• Makayla Burba, RBT
• Samantha Burk, RBT
• Marisa Lynn Burkhart
• Tommy Burns

• All providers in Plainfield, IN
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.