Miranda Wynn Bullock-Davidson, M.S., CFY-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10-027 Issued in KY

Practice address

1001 Monarch St
Ste. 110
Lexington, KY 40513-1495

Phone

(859) 224-0834

NPI assigned

May 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1104144336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MONARCH ST",
            "address_2": "STE. 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131495",
            "telephone_number": "859-224-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MONARCH ST",
            "address_2": "STE. 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131495",
            "telephone_number": "859-224-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK-DAVIDSON",
        "first_name": "MIRANDA",
        "middle_name": "WYNN",
        "name_prefix": "Mrs.",
        "credential": "M.S., CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "10-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia H. Buker, M.D.
• Saddam Bukuru
• Nolan Patrick Buland, RD LD
• Mary Patricia Bulfin
• Anna Elizabeth Bullard, LCSW
• Heather Bullock
• Jacob Andrew Bullock, D.C.
• Kirsten Lynn Bulmer
• Sarah Bumgardner, PA-C
• Edwin Lewis Bunch, M.D.

• Speech-Language Pathologist in Lexington, KY
• Providers in Lexington, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.