Active NPI
Donn Bullens Jr.
- Psychiatric/Mental Health Nurse Practitioner
- Somerville, MA
National Provider Identifier
1104366608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN2298826
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
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.