Todd E Bullock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3004076 Issued in KY

Practice address

301 Sunset Dr
Caneyville, KY 42721-9172

Phone

(270) 879-3711

Fax

(270) 879-8674

NPI assigned

Jun 22, 2005

Last updated

Nov 14, 2018By the provider in NPPES

Sex

Male

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Owensboro Health Twin Lakes Regional Medical Center, IncGroup PAC ID 3779996558, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Twin Lakes Home Health Home health agency, Leitchfield, KY, CCN 187106
• Family Home Health Care, LLC Dba Adoration Home Health Home health agency, Columbia, KY, CCN 187119
• Centerwell Home Health Home health agency, Elizabethtown, KY, CCN 187085
• Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038
• Owensboro Health Twin Lakes Medical Center Hospital, Leitchfield, KY, CCN 180070

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbullock40297@direct.owensborohealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Owensboro Health Twin Lakes Regional Medical Center, Inc

  dba Owensboro Health Twin Lakes Medical Center Family Medicine

  • Rural Health Clinic/Center
  • Caneyville, KY
  • NPI 1346846268
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Health Services USA, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Elizabethtown, KY
  • NPI 1598748600
  Care Compare affiliation
• Family Home Health Care LLC

  dba Adoration Home Health

  • Home Health Agency
  • Columbia, KY
  • NPI 1891765723
  Care Compare affiliation
• Owensboro Health Inc

  dba Owensboro Health Regional Hospital

  • General Acute Care Hospital
  • Owensboro, KY
  • NPI 1285613612
  Care Compare affiliation
• Owensboro Health Twin Lakes Regional Medical Center, Inc

  dba Owensboro Health Twin Lakes Medical Center

  • General Acute Care Hospital
  • Leitchfield, KY
  • NPI 1285221416
  Care Compare affiliation
• Twin Lakes Home Health Agency, LLC

  dba Twin Lakes Home Health

  • Home Health Agency
  • Leitchfield, KY
  • NPI 1902130446
  Care Compare affiliation

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1104822360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541479",
            "telephone_number": "270-259-1626",
            "fax_number": "270-259-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SUNSET DR",
            "city": "CANEYVILLE",
            "state": "KY",
            "postal_code": "427219172",
            "telephone_number": "270-879-3711",
            "fax_number": "270-879-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "TODD",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3004076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluegrass Occupational & Environmental Health Consulting LLC
• Kelly Ann Decker, M.S.CCC-SLP
• Embry Medical Supply
• Embry Welding Supply Inc (Embry Medical Supply)
• Andrea H. Gay, APRN
• Grayson County Hospital Foundation Inc (Twin Lakes Rural Health Clinic at Caneyville)

• Family Nurse Practitioner in Caneyville, KY
• Providers in Caneyville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.