Individual provider Active NPI

Donn Bullens Jr.

  • Psychiatric/Mental Health Nurse Practitioner
  • Somerville, MA
National Provider Identifier
1104366608
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2298826 Issued in MA
Practice address
401 Highland Ave
Somerville, MA 02144-2516
Phone
(339) 368-7696
NPI assigned
Mar 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2298826 MA Primary

Addresses

Primary practice location

401 Highland Ave
Somerville, MA 02144-2516

Mailing address

PO Box 1034
Dedham, MA 02027-1034
Phone (617) 855-2515

Other practice location 1

71 Washington St
Brighton, MA 02135-4301
Phone (339) 368-7696

Other practice location 2

339 Massachusetts Ave
Arlington, MA 02474-6718
Phone (339) 368-7696

Other practice location 3

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-1515

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104366608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1034",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020271034",
            "telephone_number": "617-855-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HIGHLAND AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442516",
            "telephone_number": "339-368-7696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Washington St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021354301",
            "country_code": "US",
            "telephone_number": "339-368-7696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "339 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "MA",
            "postal_code": "024746718",
            "country_code": "US",
            "telephone_number": "339-368-7696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781064",
            "country_code": "US",
            "telephone_number": "617-855-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLENS",
        "first_name": "DONN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2298826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.