Active NPI
Frank D Bulloch Sr.
- In Home Supportive Care Agency
- Memphis, TN
National Provider Identifier
1114768876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 000000035499
- Practice address
- 527 Mineral Rd
Memphis, TN 38120-1618 - Phone
- (190) 157-0905
- NPI assigned
- Jun 5, 2024
- 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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 000000035499 | TN | Primary |
Addresses
Primary practice location
527 Mineral Rd
Memphis, TN 38120-1618
Mailing address
527 Mineral Rd
Memphis, TN 38120-1618
Phone (901) 570-9056
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000000035499 | TN | MD | In Home Supportive Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Superior Home Care Services Inc | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Aide
- Memphis, TN
- NPI 1770458150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1114768876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 MINERAL RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381201618",
"telephone_number": "901-570-9056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 MINERAL RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381201618",
"telephone_number": "190-157-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCH",
"first_name": "FRANK",
"middle_name": "D",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-05",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "TN",
"license": "000000035499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.